Shoulder Instability Trial Comparing Arthroscopic Stabilization Benefits Compared With Latarjet Procedure Evaluation - STABLE Definitive Trial (STABLE-2)
Shoulder Dislocation, Sport Injuries, Anterior Dislocation
About this trial
This is an interventional treatment trial for Shoulder Dislocation
Eligibility Criteria
Inclusion Criteria: Men and women ages 18-50 years; Diagnosis of post-traumatic recurrent anterior dislocation. This will require a minimum of 2 episodes of documented dislocations either by radiographic evidence or documented reduction of anterior shoulder dislocation as well as physical examination eliciting unwanted glenohumeral translation with reproduction of symptoms; Mild glenoid bone loss as defined on CT by standardized and reproducible best-fit circle technique (>10% but <20%); Provision of informed consent. Exclusion Criteria: Patients with concomitant injuries (cuff tear); Previous shoulder surgery; Patients that will likely have problems, in the judgment of the investigators, with maintaining follow-up; Epilepsy/seizure disorder; Patients who are or at risk of being incarcerated; Diagnosis of multidirectional instability; Cases involving litigation or workplace insurance claims (e.g. WSIB); Confirmed connective tissue disorder (Ehlers-Danlos, Marfans) or Beighton hypermobility score > 6. Pregnancy.
Sites / Locations
- St. Joseph's Healthcare HamiltonRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Bankart + Remplissage Procedure
Latarjet Procedure
Bankart Procedure: the participant will be placed in the lateral decubitus or beach chair position. Standard diagnostic arthroscopy will be performed. The anterior capsulolabral complex will be freed from the anterior aspect of the scapular neck. The anterior aspect of the scapular neck will be decorticated using a motorized burr. A capsuloligamentous repair will be performed with the capsule shifted from inferior to superior and repaired on the glenoid face. The number of anchors used for the repair will be left to the discretion of the surgeon. Patients will be given a sling for 4 weeks, and participation in sports will not be allowed for 6 months.
Open or Arthroscopic coracoid transfer (Latarjet Procedure): This procedure may be performed through small incisions (minimally invasive) but may require a larger incision in some cases. It involves the transfer of a nearby bony structure (the coracoid process) to the front of the shoulder joint (glenoid). This bone will then provide support to prevent the shoulder joint from dislocating.