Current Trends and Innovations in Arthroscopic Shoulder Surgery

Dear Colleagues,

Over the past two decades, reconstructive procedures of the shoulder and adjacent joints have become increasingly popular worldwide and are currently predominantly carried out arthroscopically or via minimally invasive procedures. This was made possible in particular by the better understanding of pathomorphological changes in various shoulder diseases and the development of novel implants, instruments and surgical techniques.

The focus of rotator cuff surgery has primarily been on biomechanical and clinical studies that have examined the value of various reattachment techniques. Despite the establishment of highly stable constructs, clinical outcomes have not improved significantly. The level of primary stability has probably been reached or even exceeded here and the future will involve the biological enhancement of the reconstruction in order to further reduce the rate of re-tears. New approaches exist primarily in the joint-preserving treatment of irreparable or partially repairable ruptures. Different superior capsular reconstruction techniques and modern muscle transfer options to replace or augment the insufficient musculotendinous units of the rotator cuff are currently being tested in clinical research and are increasingly transitioning to clinical practice. Modern methods of capsular labrum reconstruction in the treatment of shoulder instability are now part of the standard arthroscopic repertoire and it is hoped that if the indication is correct, the recurrence rates can be further reduced in the long term. The quantification and consideration of significant bony defects in the shoulder joint make a decisive contribution to the success of the surgical treatment of shoulder instability.

Huge progress has also been made in traumatological shoulder surgery in recent years. While the treatment of glenoid and greater tuberosity fractures has long been carried out arthroscopically with very good clinical results, the range of indications for minimally invasive techniques has also been expanded to include more complex fracture situations of the scapula. The same applies to the the treatment of lateral clavicle fractures and acromioclavicular joint sprains. Arthroscopic or arthroscopic-assisted techniques avoid extensive soft tissue preparation with relevant access morbidity, and allow for the simultaneous treatment of accompanying glenohumeral pathologies. Obligatory second interventions can also be avoided.

The aim of this Special Issue is to give you an overview of established approaches and current innovations in reconstructive shoulder surgery.

With this in mind, we hope you enjoy reading through the following articles.

Prof. Dr. Markus Scheibel
Prof. Dr. Sebastian Siebenlist
Dr. Lucca Lacheta
Guest Editors

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• shoulder and adjacent joints
• arthroscopic surgery
• rotator cuff surgery
• reconstructive shoulder surgery
• minimally invasive surgery