head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue1
Subject Area: Medicine
DOI: 10.5272/jimab.2019251.2349
Published online: 05 February 2019

Original article

J of IMAB. 2019 Jan-Mar;25(1):2349-2354
Boris MatevORCID logo Corresponding Autoremail, Svetoslav SlavchevORCID logo,
University Hospital of Orthopaedics and Traumatology Prof. B. Boychev, Medical University, Sofia, Bulgaria.

Purpose: The goal of this study is to present the results after different methods of surgical treatment of the unstable shoulder joint: arthroscopic stabilization; arthroscopic stabilization followed by the operative technique of Matev and the Latarjet procedure in cases of presence of bone defects.
Materials and methods: For the period from 2004 to 2017, 291 patients between 15 and 35 years were operated at University Hospital “Prof. B. Boychev”- Medical University - Sofia. 247 of them were with anterior and 44 with combined shoulder instability. 173 of the patients were active athletes practicing different disciplines. The average age of appearance of the first dislocation was 17 years. In 172 patients, the first dislocation came without significant trauma, 124 of them had an anterior shoulder instability and 48- combined shoulder instability. In 120 patients with anterior dislocations, there was a serious injury during the first accident. The number of dislocations varied between ten and fifteen in all patients.
For the same period, 45 patients with significant bone defects underwent open surgery (Latarjet – procedure). In the cases with bone defects, there were between 8 and 30 dislocations before the first examination. There were 11 patients, who underwent previous surgery in other hospitals andthey came in our clinic with а different number of postoperative reluxations.
Results: The results were evaluatedradiographically and clinically. Functionally, the patients recovered according to a well-established protocol. Full range ofexternal rotation was observed. All of them returned to sports activity.
Conclusions: This combined operative technique tends to be the most effective method in the treatment of shoulder dislocations, especially in people who want a quick return to active sports.

Keywords: shoulder instability, arthroscopic stabilization, combined operative technique, Latarjet procedure,

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Please cite this article as: Matev B, Slavchev S. SHOULDER INSTABILITY – A FREQUENT PATHOLOGY – VARIOUS METHODS OF TREATMENT. J of IMAB. 2019 Jan-Mar;25(1):2349-2354. DOI: 10.5272/jimab.2019251.2349

Corresponding AutorCorrespondence to: Boris Matev, University Hospital of Orthopaedics “Prof. B. Boychev”, Medical University of Sofia; 56, Nikola Petkov Blvd., 1614 Sofia, Bulgaria; E-mail: bimatev@abv.bg

1. Burkhart SS, Debeer JF, Tehrany AM, Parten PM. Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy. 2002 May-Jun;18(5):488-91. [PubMed] [Crossref]
2. Hantes M, Raoulis V. Arthroscopic Findings in Anterior Shoulder Instability. Open Orthop J. 2017 Feb 28;11:119-132.  [PubMed] [Crossref]
3. McIntyre LF, Caspari RB, Savoie FH 3rd. The arthroscopic treatment of posterior shoulder instability: two-year results of a multiple suture technique. Arthroscopy. 1997 Aug;13(4):426-32. [PubMed] [Crossref]
4. Dimitrov N, Vassilev I, Tsekov P. Arthroscopic techniques for stabilization of the shoulder joint. Compendium of reports, IX Congress of BOTA with International Participation, Plovdiv. 2004; 226-228. [in Bulgarian]
5. Dimitrov N, Matev B, Georgiev H, Kateva M, Gercev A. Aged locked posterior dislocation of the shoulder - combined surgical treatment; Comptesrendus de l’Academiebulgare des Sciences. 2018; 71(5):704-711.
6. Dimitrov N, Matev B, Georgiev H, Matev V, Andreev A, Georgiev GP. Shoulder instability - combined surgical treatment. C R Acad Bulg Sci. 2013; 66(7):1063-1072.
7. Dimitrov N, Tsekov P. Operative stabilization of anterior instability according to the principles of Latarjet. Collection of reports, IX Congress of BOTA with international participation, 2004, Plovdiv, ISBN 954 - 9752 - 33 - X, 221 -223. [in Bulgarian]
8. Dimitrov N, Tsekov P, Lazarov L, Kirov Z, Matev B, Popov N. Endoprosthesis in aged fractures - shoulder luxations; Collection of reports, X Anniversary Congress of BOTA, Borovets. 2007;123-125. [in Bulgarian]
9. Blundell Bankart AS. The pathology and treatment of recurrent dislocation of the shoulder-joint. BJS. 1938 Jul;26(101):23-29. [Crossref]
10. Gill TJ, Micheli LJ, Gebhard F, Binder C. Bankart repair for anterior instability of the shoulder. Long-term outcome. J Bone Joint Surg Am. 1997 Jun;79(6):850-7. [PubMed]
11. Kirov Z, Tzekov P, Matev B., Lazarov L, Dimitrov N. Stabilization of the anterior shoulder instability with the modified method of Boichev. Results in 74 cases. Collection of Reports, X. Jubilee Congress of BOTA, Borovets. 2007; 105-107. [in Bulgarian]
12. Dimitrov, MPT Post-traumatic Shoulder Diagnosis, MRI of the Posttraumatic Shoulder, XV Congress of BAR, Collection of Lectures and Reports, Rentgenology: & Radiology, Suppl 2013;42 -3
13. Popov N, Popova D, Dimitrov N. Kinesiological justification of the kinesitherapeutic approach after surgical treatment of impingement syndrome. Collection of papers, IX Congress of BOTA with International Participation, Plovdiv. 2004; 313-15.
14. Popov N, Dimitrov N, Popova D. Functional reconstruction of the shoulder complex after arthroscopic sub-macromolecular decompression. Collection of reports, X Anniversary Congress of BOTA, Borovets. 2007; 217-20. [in Bulgarian]
15. Dimitrov N, Tzekov P, Mazneykov Hr, Popov N. Results after the arthroscopic surgical treatment of the shoulder instability. Collection of papers, X Anniversary Congress of BOTA, Borovets. 2007;90-93. [in Bulgarian]
16. Yang JS, Mazzocca AD, Cote MP, Edgar CM, Arciero RA. Recurrent Anterior Shoulder Instability With Combined Bone Loss: Treatment and Results With the Modified Latarjet Procedure. Am J Sports Med. 2016 Apr; 44(4):922-32. [PubMed] [Crossref]
17. Matev I, Matev V. Modifizierte Boychev operation bei recidiverder schulter gelenks luxation bei profesionalen sportsmen. Dtsch Z Sportmed. 1992; 43:304–308.  [in German]
18. Katthagen JC, Anavian J, Tahal DS, Millett PJ. Arthroscopic Remplissage and Open Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability with Severe Bipolar Bone Loss. Arthrosc Tech. 2016 Oct 10;5(5):e1135-e1141. [PubMed] [Crossref]
19. Kartus C, Kartus J, Matis N, Forstner R, Resch H. Long-term independent evaluation after arthroscopic extra-articular Bankart repair with absorbable tacks. A clinical and radiographic study with a seven to ten-year follow-up. J Bone Joint Surg Am. 2007 Jul;89(7):1442-8. [PubMed] [Crossref]
20. Dimitrov N. [Shoulder stiffness - causes and ways of treatment.] Medicine and Sport. 2012 Aug(3-4):16-21.[in Bulgarian].

Received: 12 October 2018
Published online: 05 February 2019

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