Background: Engaging Hill-Sachs lesions are known to be a risk factor for recurrence dislocation after arthroscopic repair in patients with anterior shoulder instability. For a large engaging Hill-Sachs lesion, arthroscopic remplissage is a solution.

Very few studies have compared open Latarjet versus arthroscopic Latarjet procedures. To compare the clinical and computed tomographic outcomes between open and arthroscopic Latarjet procedures. Cohort study; Level of evidence, 3. A prospective, comparative study was performed. The open Latarjet group included 44 patients, and the arthroscopic Latarjet group included 46 patients. All patients had more than 2 years of clinical follow-up (range of motion, American Shoulder and Elbow Surgeons [ASES] score, Constant-Murley score, and Rowe score). The position of the transferred coracoid, the screw orientation, and graft resorption were evaluated on computed tomography (CT) scan. The surgery time for the open group was significantly shorter than that for the arthroscopic group (P = .003). No recurrent dislocation occurred in either group. The apprehension test was negative in all patients in both groups. At the final follow-up, no significant difference was detected between the open group and the arthroscopic group regarding any of the clinical outcome measurements. The transferred coracoid graft was level with the glenoid in all patients in both groups. The open group had better position in the superior-inferior direction compared with the arthroscopic group (P < .001). No significant difference was found in screw orientation between the 2 groups (P = .102). At 1 year after surgery, patients in the arthroscopic group had significantly less resorption compared with patients in the open group (P = .044). Both procedures are effective for the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss. The open group had better position in the superior-inferior direction compared with the arthroscopic group. At 1 year after surgery, patients in the arthroscopic Latarjet group showed notably less graft resorption compared with patients in the open Latarjet group.

Background: We report an alternative to the modified Weaver-Dunn technique that can achieve stable coracoclavicular reconstruction while avoiding sacrifice of the coracoacromial arch. The purpose of this study was to retrospectively analyze the functional outcomes and radiographic features of patients treated with coracoclavicular ligament reconstruction with use of a proximally based conjoined tendon transfer. Methods: The cases of thirty-eight patients with type-IV, type-V, and selected type-III acromioclavicular dislocations according to the Rockwood classification system, who were followed for an average follow-up of 38.7 months, were evaluated retrospectively. Transfer of the lateral half of the conjoined tendon to the distal aspect of the clavicle in a proximally based fashion, with additional coracoclavicular fixation, was performed in all patients. At the latest follow-up evaluation, radiographic analysis and the scores on the American Shoulder and Elbow Surgeons, Constant and Murley, and Simple Shoulder Test questionnaires were used to provide a final evaluation of shoulder function. The ability to return to work and the ability to return to sports were also recorded. Results: At the time of final follow-up, the mean American Shoulder and Elbow Surgeons score was 91.4, with a mean pain score on the visual analog scale of 1.8, mean forward flexion of 148.2°, and mean external rotation of 38.0°. The mean Constant and Murley score was 90.6. The new number of positive answers on the Simple Shoulder Test was 10.9. The overall rate of satisfaction (an excellent or good result) was 89% (thirty-four patients). Thirty-five (92%) of the thirty-eight patients returned to their previous work, and thirty-two (84%) returned to their preinjury level of sports. Conclusions: The proximally based conjoined tendon transfer is a reliable treatment for a high-grade acromioclavicular dislocation. The lateral half of the conjoined tendon is a safe graft source with ample length, and this technique avoids sacrifice of the coracoacromial ligament. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Background: Aortoenteric fistula (AEF) is a rare cause of gastrointestinal bleeding and is often misdiagnosed in clinical practice. Herein, a case series of AEFs are presented and the clinical characteristics, diagnosis, and management strategies are summarized.Methods: A retrospective analysis was performed on consecutive hospitalized patients with a final diagnosis of AEF at Beijing Friendship Hospital, Capital Medical University, between January 1, 2007 and March 31, 2020. The clinical data including diagnostic and management procedures as well as outcomes were collected and summarized.Results: A total of nine patients were included in this study, five with primary AEF and four with secondary AEF. Eight of the patients were male, and the median age was 63 years. The fistulas were located in both the small intestine and the colon. All patients presented with gastrointestinal bleeding and pain, followed by weight loss, anorexia, and fever. A typical abdominal triad was found in only two cases. Seven patients experienced complications with preoperative abdominal infections and sepsis, and multiple organ failure occurred in four of these patients. All patients were assessed by computed tomography and five underwent abdominal and/or iliac aorta angiography. Two of these patients showed contrast agent leakage from the abdominal aorta into the intestine. Two cases were diagnosed with AEF by endoscopy before the operation. Eight patients received surgery and six patients survived.Conclusions: AEF is a rare cause of gastrointestinal bleeding that is associated with high mortality. Gastrointestinal bleeding and pain are the most common presentations. Timely diagnosis and multidisciplinary management are crucial to achieve a positive outcome.