Bipolar Lock

Bipolar locking is an arthroscopic stabilization of a shoulder whose objective is to repair the lesions caused by anterior dislocations (in particular)

Regarding anterior and inferior lesions:

The classic intervention of ‘Arthroscopic Bankart’:

It includes a good repositioning of the antero-inferior labrum and inferior glenohumeral ligament with resorbable or metallic small anchors (2-3 mm)

Associated gestures according to the case:

• reinsertion of the upper labrum or tenodesis of the biceps in case of instability (SLAP) or associated tendonitis, sometimes using an anchor or a tunnel in the bone

• bone reinsertion in case of fracture if it is technically possible (anchors or screws)

the most obvious lesion, when present, is the posterior notch at the level of the humeral head resulting from the impact of the head on the glenoid during articular dislocation.

It is a bone settlement rather than a cookie cutter.

It is voluminous and can be seen on standard X-rays of the shoulder and on MRI or CT scans.

They are sometimes minimal or invisible on the exams but undoubtedly lesions are in our opinion systematically present in the joint capsule and infra-spinous tendon that have been stretched at least during joint dislocations.

A posterior repair procedure is performed at this level in the form of a capsulo-tenodesis (fixation-retentation of the capsule and infra-spinous tendon)

For this purpose, we perform a posterior capsulotendinous fixation of the zone close to that without cartilage of the humeral head and not at the notch because of the extreme variation of position of these posterior notches that are not always ‘refillable’ ( or with a possible functional limitation of the shoulder).

In total :

Surgical procedures performed before are rarely practiced in isolation because it is now accepted in the profession that this is not sufficient for the majority of patients operated true relapsing dislocations. They are now made jointly with with a stabilization back.

We have developed at the Union clinic the principle of BIPOLAR LOCK, which has a double anterior and posterior stabilization, which gives much better results than an isolated anterior stabilization.