I'm 70 years old but still quite active. Last year, I fell and dislocated my shoulder. It never healed right and keeps popping out of the socket. I saw a surgeon who wants to do some kind of a bony bridge to stick a piece of bone back into the socket. Am I "too old" for something like this? I know I don't heal like I used to and this sounds ... complicated.
The procedure you are referring to is most likely the Bony Bankart Bridge. As you described, it is a technique used to restore a fractured glenoid (shoulder socket). The Bony Bankart Bridge (BBB) addresses the bone loss by reattaching the bone fragment back into its "donor bed" (original place).
A special bridging technique using push-lock knotless suture anchors reconstructs the shoulder and restores stability. There is no hardware where the two bony edges meet (where healing takes place). The surgeon also repairs any soft tissue damage to the capsule, labrum, and glenohumeral ligament. Care is taken to avoid tilting the bony piece, which could lead to over- or under-correcting the problem.
The greatest significance of this technique is that it was done completely by arthroscopic techniques. In other words, no open or large incisions were made to give the surgeon access to the area. All-arthroscopic procedures are becoming more common now even for difficult-to-treat problems like this one. The goal of this treatment is to restore the surface area of the shoulder socket and prevent any more dislocations.
It is important to address the problem of a chronic shoulder instability. Chronic shoulder instability means the shoulder continues to dislocate over and over. Pain, fear of movement that might cause another dislocation, and loss of function for daily activities can be very bothersome. With each dislocation can come further damage to the soft tissues and especially the bony rim around the shoulder socket. These microtraumas cause the bony rim around the shoulder socket to break away taking with it the attached soft tissues.
Studies have shown that a loss of 20 per cent (or more) of the bony rim significantly increases contact pressure (bone on bone). This type of bone loss also reduces resistance to dislocation. And with this type of bone deficiency, there is a high rate of failure after surgical repair of the soft tissues.
The type of injury you have is not that common and the all-arthroscopic surgical technique is fairly new. Newer, more advanced arthroscopic techniques have been developed that allow for this type of reconstruction of bone defects. And according to a recent study, this new all-arthroscopic repair for a mild-to-moderate Bankart lesion can restore shoulder stability.
Patients of all ages (up to and including 70-year-olds), experienced significant pain relief and return to normal (or near normal) function. The Bony Bankart Bridge technique may help avoid the high failure rates normally associated with this type of bony reconstruction procedure when they are done with an open incision.
Peter J. Millett, MD, MSc, et al. The "Bony Bankart Bridge" Technique for Restoration of Anterior Shoulder Instability. March 2013. Vol. 41. No. 3. Pp. 608-614.
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