The novel arthroscopic subscapular sling procedure grants better stability than an arthroscopic Bankart repair in a cadaveric study

Abstract

Purpose: This novel arthroscopic subscapular sling procedure stabilizes the shoulder using a semitendinosus graft to create a sling around the subscapular tendon, which provides both static and dynamic stability. The aim of the study was to evaluate the biomechanical stability of the subscapular sling procedure in human cadaveric shoulders. The hypothesis was that the sling ofers an equal stabilizing efect and range of motion compared to an arthroscopic Bankart repair. Methods: Sixteen shoulders were investigated using an industrial robot-based testing platform and four diferent conditions: the physiologically intact shoulder, after creating a Bankart lesion, after arthroscopic Bankart repair, and fnally after applying the subscapular sling procedure using a semitendinosus tendon graft. Joint translation and external rotation were evaluated for each condition. Results: The results show improved stability in the shoulders with the subscapular sling. The robot testing revealed a signifcant reduction in translation in anterior and anterior–inferior directions compared to the arthroscopic Bankart repair. None of the shoulders were dislocated by forced manual abduction and external rotation. No difculties were encountered in performing the arthroscopic subscapular sling procedure. Thorough postoperative anatomical dissection showed no alterations to structures at risk. Conclusion: The biomechanical results show increased stability with the use of the subscapular sling method