The Role of Arthroscopy in Revision of Failed Open Anterior Stabilization of the Shoulder
Bibliographic record
Abstract
PURPOSE: The purpose of this study was to evaluate the results of revision arthroscopic stabilization after failed open anterior shoulder stabilization. METHODS: We studied a retrospective series of 22 consecutive patients with recurrent anterior shoulder instability after open surgical stabilization (12 Latarjet procedures, 4 Eden-Hybinette procedures, 3 open Bankart repairs, and 3 capsular shifts). Failure was associated with a traumatic episode in 12 patients, capsular laxity with persistent Bankart lesions in all patients, and a bone block complication in 13 patients. Labral reattachment and capsuloligamentous retensioning with suture anchors were performed in all cases. An additional rotator interval closure was performed in 4 cases and an inferior capsular application in 12. Bone block screws were removed during arthroscopy in 8 patients because of malpositioning or mobility. Nineteen patients were evaluated at a mean follow-up of 43 months. RESULTS: All patients returned to their previous occupations, including 6 cases of work-related injury. Of the patients, 1 (5%) had recurrent subluxation and 2 (11%) had persistent apprehension. The subjective shoulder value was 83% +/- 23%. A good or excellent result was found in 85% of patients according to the Walch-Duplay score and 13 patients (67%) according to the Rowe score. Shoulder pain was found in 6 patients (32%) (4 with light pain and 2 with moderate pain). Of the 5 patients with osteoarthritis before surgery, 3 progressed by 1 stage. CONCLUSIONS: Arthroscopic revision of failed open anterior shoulder stabilization provides satisfactory results in a selected patient population. Some persistent pain and osteoarthritis progression remain concerns. The main advantages of the arthroscopic approach are the avoidance of anterior dissection in front of the subscapularis, which places the axillary nerve at risk, and the ability to address the various soft-tissue pathologies encountered. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".