Study on Recurrent Anterior Shoulder Dislocation: An Approach to Boytchev Treatment

The Boytchev procedure, which has been used to treat anterior glenohumeral instability since 1951, is an open anterior repair that involves rerouting the muscles that connect the coracoid process to the subscapularis muscle between this and the capsule. The tip of the coracoid is reattached to its base by its muscles in the anatomical position.

Methods: We studied twenty patients who had repeated shoulder dislocations and were treated with the Boytchev technique in a prospective trial. With an average age of 29.2 years, they are all men (age range from 17 to 42 years). The right shoulder was impacted in 14 cases, while the left shoulder was affected in 6. Every single one of them has a history of recurring dislocation. We also conducted a literature search (16),17 studies, including ours, with the goal of estimating, via statistical analysis, the post-operative results of recurrent anterior dislocations of the shoulder, in order to determine the reliability of this technique and possible specific risk factors that may lead to recurrence.

Results: In our series, 19 patients had outstanding and good results using the Rowe score; one patient, who had a recurrence, had a bad result in terms of stability. Another patient was diagnosed with osteoarthritis. The total number of patients in the 17 studies is 477, including 485 dislocated shoulders. The recurrence rate is 7.33 percent. The rate is 2% in 12 trials against 21.05 percent in 5 studies, with a significant difference (1-p=99.89%). In terms of result grading, we have 441 excellent and good results and 44 fair and poor outcomes (91 percent versus 9% with p=>99.9%, which is also highly significant).

Conclusion: Based on accumulated data, the Boytchev treatment has a low recurrence rate and so may be deemed a viable surgical approach.

Author (S) Details

Otman Benabdallah
Centres Hospitaliers de Tanger, Morocco.

Ahmed Khamlichi
Centres Hospitaliers de Tanger, Morocco.

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