Evaluation of glenoid capsulolabral complex insertional anatomy and restoration with single- and double-row capsulolabral repairs.

BACKGROUND: The purpose of this study was to evaluate the normal glenoid insertional anatomy of the anterior-inferior capsulolabral complex and to compare the ability of a single-row repair and a double-row suture bridge repair to restore the insertional anatomy. METHODS: Eight fresh frozen cadaver shoulders were dissected and the native glenoid insertion of the anterior-inferior capsulolabral complex was digitized. Bankart lesions were created, the shoulders were randomized to receive either the standard single-row suture anchor repair or a double-row suture bridge repair, and the insertion repair sites were then digitized. RESULTS: The single-row repair recreated 42.3% of the native footprint surface area while the double-row repair recreated 85.9%. The double-row repair was significantly larger and recreated significantly more of the native footprint compared with single-row repair (P < .01). CONCLUSION: Double-row repair of the capsulolabral complex reestablishes the native insertional footprint on the anterior inferior glenoid better than a single-row repair. LEVEL OF EVIDENCE: Basic science study.

Clinical and Radiographic Outcomes of Total Shoulder Arthroplasty With a Hybrid Dual-Radii Glenoid Component.

In total shoulder arthroplasty (TSA), glenoid prostheses have conforming or nonconforming designs. A hybrid glenoid was designed with dual radii of curvature: a central conforming region surrounded by an outer nonconforming region. We retrospectively reviewed the cases of 169 patients who underwent 196 hybrid glenoid prosthesis TSAs for primary glenohumeral arthritis. Clinical data, retrieved for 178 shoulders at a mean follow-up of 4.8 years, included physical examination, 36-Item Short Form Health Survey (SF-36), American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), subjective Neer criteria, and postoperative complication data. Radiographic data were retrieved for 136 shoulders at a mean of 3.7 years. Kaplan-Meier survivorship analysis was performed with glenoid or humeral revision as the endpoint. All range of motion and survey measures improved in a statistically significant manner (P < .001). Of 139 respondents, 130 (93.5%) stated they were satisfied or very satisfied with their TSA. Of 178 patients, only 3 (1.7%) required revision for component loosening: 2 glenoid and 1 humeral. Of 136 shoulders, 86 (63.2%) had no glenoid lucencies, and 91 (66.9%) had no humeral stem lucencies. Use of a hybrid-congruency glenoid prosthesis had excellent intermediate clinical and radiographic outcomes in the treatment of primary glenohumeral osteoarthritis.