PMID- 38453096 OWN - NLM STAT- Publisher LR - 20240410 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) DP - 2024 Mar 5 TI - The Arthroscopic Subscapular Sling Procedure Results in Low Recurrent Anterior Shoulder Instability at 24 Months of Follow-Up. LID - S0749-8063(24)00167-1 [pii] LID - 10.1016/j.arthro.2024.02.032 [doi] AB - PURPOSE: To analyze the results of the subscapular sling procedure developed for anterior shoulder instability in patients with less than 10% anterior glenoid bone loss. METHODS: Patients were treated surgically with the arthroscopic subscapular sling procedure. A semitendinosus graft was used to reconstruct the anterior labrum and to establish a sling suspension around the upper part of the subscapularis tendon. The patients were followed up with radiographs (at 12 and 24 months). Magnetic resonance imaging (MRI) of the shoulder region and clinical examinations were performed at 3, 12, and 24 months. Recurrent dislocation was the primary endpoint. The Western Ontario Shoulder Instability Index (WOSI) and MRI results were secondary outcome measures. An independent physiotherapist assessed residual instability and range of motion. RESULTS: Fifteen patients were included with a dislocation rate of 0% after 24 months follow-up. There was a significant clinical improvement of the WOSI score from 57% (904) at baseline to 88% (241) at 24 months (P < .001). The proportion of patients with an improvement in the WOSI Total score larger than the estimated minimal clinically important difference was 100% both at 12 and 24 months. MRI showed an intact sling in all patients. External rotation was not significantly reduced (52 degrees at baseline vs 47 degrees at 24 months, P = .211). Flexion and abduction were significantly improved from 152 degrees to 174 degrees (P = .001) and 141 degrees to 170 degrees (P < .001) after 24 months. The surgical procedures were completed without any intraoperative complications. CONCLUSIONS: The subscapular sling procedure resulted in low recurrent shoulder instability and improved patient-reported outcome measures at 24 months of follow-up. LEVEL OF EVIDENCE: Level IV, case series. CI - Copyright (c) 2024 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Klungsoyr, Jan Arild AU - Klungsoyr JA AD - Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Orthopedic Surgery, Alesund Hospital, More and Romsdal Hospital Trust, Alesund, Norway. Electronic address: janarild.klungsoyr@gmail.com. FAU - Vagstad, Terje AU - Vagstad T AD - Department of Orthopedic Surgery, Alesund Hospital, More and Romsdal Hospital Trust, Alesund, Norway. FAU - Klungsoyr, Peter Johannes AU - Klungsoyr PJ AD - Department of Orthopedic Surgery, Alesund Hospital, More and Romsdal Hospital Trust, Alesund, Norway. FAU - Myklebust, Tor Age AU - Myklebust TA AD - Department of Research and Innovation, More and Romsdal Hospital Trust, Alesund, Norway. FAU - Lund Hanssen, Hakon AU - Lund Hanssen H AD - Department of Radiology and Nuclear Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. FAU - Hoff, Solveig Roth AU - Hoff SR AD - Department of Radiology, Alesund Hospital, More and Romsdal Hospital Trust, Alesund, Norway; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. FAU - Drogset, Jon Olav AU - Drogset JO AD - Department of Orthopedic Surgery, Trondheim University Hospital and Norwegian University of Science and Technology (NTNU) Trondheim, Norway. LA - eng PT - Journal Article DEP - 20240305 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 SB - IM COIS- Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The study was funded by Aalesund Hospital, More and Romsdal Health Trust and the Norwegian University of Science and Technology (Liaison committee), Trondheim, Norway. All authors (J.A.K., T.V., P.J.K., T.A.M., H.L.H., S.R.H., J.O.D.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/03/08 00:43 MHDA- 2024/03/08 00:43 CRDT- 2024/03/07 19:20 PHST- 2023/10/23 00:00 [received] PHST- 2024/02/18 00:00 [revised] PHST- 2024/02/24 00:00 [accepted] PHST- 2024/03/08 00:43 [pubmed] PHST- 2024/03/08 00:43 [medline] PHST- 2024/03/07 19:20 [entrez] AID - S0749-8063(24)00167-1 [pii] AID - 10.1016/j.arthro.2024.02.032 [doi] PST - aheadofprint SO - Arthroscopy. 2024 Mar 5:S0749-8063(24)00167-1. doi: 10.1016/j.arthro.2024.02.032.