My Arthroscopic Bankart Failed, Now What? (AANA25)-My Arthroscopic Bankart Failed, Now What? Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization

My Arthroscopic Bankart Failed, Now What? Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization

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Video Summary

In a detailed session led by Albert Lin from the University of Pittsburgh at an ICO conference, discussions focused on managing arthroscopic vanguard surgery failures. The panel, including Ivan Wong, Kat Coyner, and Aman Dwan, delved into various treatment options for addressing the high failure rates of the initial surgeries. Lin highlighted a 30% failure rate at the 10-year mark for arthroscopic vanguard, emphasizing the importance of understanding bone loss as a dimension in treatment plans. Different approaches, including open revision options, were shared. Lin talked about revision measures, indicating that patient selection is paramount when considering arthroscopic revision vanguard with or without a remplissage to preserve subscapularis and evaluate labral pathology, among other benefits. A higher rate of recurrent dislocation and complications associated with revision procedures was also noted. Aman Dwan presented on open Bankart and Latergé techniques, citing literature supporting open Bankart for cases of minimal bone loss and hyperlaxity, but highlighting the complexities involved with open Latergés. Kat Coyner discussed the relevance of bone augmentation techniques such as distal tibia allograft (DTA), stressing accurate assessment of bone loss. She also mentioned alternative approaches like iliac crest or distal clavicle grafts, emphasizing the crucial role of optimal technique. Ivan Wong underscored the learnability of arthroscopic anatomical glenoid reconstructions (AAGR), touting its safety and efficacy. Case discussions illustrated the application of these strategies in complex scenarios, stressing careful consideration of factors like bone loss, seizure history, and patient activity level in choosing appropriate treatment modalities.

Asset Caption

Albert Lin, M.D. | Aman Dhawan, M.D. | Katherine J. Coyner, M.D, M.B.A. | Ivan H. Wong, M.D., FAANA

Keywords

arthroscopic surgery

vanguard surgery failures

Albert Lin

bone loss

revision options

open Bankart

Latergé techniques

bone augmentation

distal tibia allograft

arthroscopic anatomical glenoid reconstructions

treatment modalities