A new technique for the treatment of shoulder instability has been identified, taking inspiration from ancient woodworking design. Known as the ‘Inlay Bristow’ technique, the arthroscopic procedure has shown a high success rate for patients experiencing recurrent shoulder instability.
Here, we will look at the new technique and what it could mean for patients. You will also discover more about shoulder instability and its symptoms.
What is the Inlay Bristow technique?
Currently, the Bristow-Latarjet procedure is one of the most commonly used techniques. This involves taking a small piece of bone from the scapula before fixing it to the glenoid bone. While it does have a great success rate in terms of providing long-term stability, it isn’t without its problems. If the graft doesn’t heal properly, it results in a non-union, potentially leading to bone deterioration or breakage of the screw.
The Inlay Bristow technique was inspired by an ancient woodworking technique which used mortise and tenon joints. In the procedure, a tenon is created by trimming the coracoid graft. It is then fixed into the mortise which has been created in the glenoid bone. The technique is said to optimise the accuracy of graft positioning.
A study was carried out to determine how effective this approach would be. Initial results proved promising and were published in The Journal of Bone & Joint Surgery.
Understanding the study
The study into the new technique was carried out by the Peking University Third Hospital. It included 51 patients who underwent the procedure for recurrent shoulder instability. After one year, in 96% of patients the coracoid bone graft had completely healed. CT scans were carried out at follow up appointments which showed little or no bone degeneration and good graft positioning.
The technique also showed to improve function. Significant improvements were recorded in shoulder stability as well as overall joint function. A staggering 87% of patients were also able to return to sport.
What is shoulder instability?
Shoulder instability occurs when the ligaments, labrum or the lining of the shoulder joint become torn, stretched or detached. This causes the ball of the joint to move partially, or completely, out of its socket.
It can be caused by repeated shoulder movements or trauma to the joint. The type of instability you have will determine the treatment you require. For example, a labral tear will be treated differently to a dislocation.
Most patients can be treated non-surgically, depending upon the type of shoulder instability they experience. However, a full consultation will be required to assess the extent of the issue. This will allow the specialist to determine the best course of treatment moving forward. The new tenon and mortise technique could prove a viable treatment options for patients in the future. However, further studies will need to be carried out to determine its suitability and safety.