Background
Rotator cuff tears (RCT) are common . Reappear rate after repair varies in literature between 10 and 75% .
In the last decade, multiple studies showed variable results of RCR augmented with different varieties of patches .

Objectives
Systematic review&meta-analysis to compare the clinical and radiological outcomes of augmented RCRs versus controls.

Study Design & Methods
We searched medical electronic databases& clinical trial registry through April 2022
Our inclusion criteria were: (RCTs) and observational studies that compared augmented RCR versus controls; age of above 18 years.We excluded studies using the patch to bridge tears ,superior capsule reconstruction&studies not accessible in English;
The primary outcome measures were rate of RCR failure and adverse events. The secondary outcomes were Constant scores, American Shoulder and Elbow score(ASES)&VAS for pain scores.

Results
Nine studies were included.The overall pooled estimate showed no significant difference between the graft and control groups in terms of the ASES and Constant scores. However, the allograft& autograft subgroups showed less re-tear rate .The autograft group showed higher AES score while both auto&allograft groups showed higher constant scores .The VAS score showed overall less pain in Augmentation group except no difference found with Xenografts.The overall risk ratio did not favour either of the two compared groups

Conclusions

Pooled analysis showed that rotator cuff repair with patch augmentation is associated with a lower re-tear rate& no increased rate of adverse events compared with repairs without patch augmentation. Furthermore, auto& allograft patch augmentation showed significantly better functional outcome and less postoperative pain.

In this study we evaluate functional and radiological results of the
arthroscopic Bankart repair using glenoid neck abrasion and inferior
Capsular shift to reattach the labrum to the glenoid followed by immobilizing
the shoulder between 3 and 6 weeks in neutral rotation to allow healing.
41 patients with Bankart lesion and recurrent anterior shoulder dislocation,
aged between 16 and 40 years, underwent arthroscopic inferior capsular
shift, glenoid neck abrasion followed by postoperative immobilization in 20
degrees abduction and neutral rotation. Pre and postoperative evaluations
included detailed physical examination, assessment with the Neer and
Constant scale for shoulder functions and MRI were done. The mean follow up was 40.8 months
(from 12 to 55 months).
Forty patients were reexamined. According to Neer score, the results were
excellent in 38 patients (95%) and satisfactory in 2 patients (5%).
Preoperative mean Constant scale was 64.2 and 87.6 postoperatively. The
mean preoperative active external rotation was 45° increased
postoperatively to 62° respectively. In 33cases postoperative MRI after
more than 6 months from surgery was done, and in 29 of these cases the labrum was healed to the glenoid.

Introduction:The aim of this retrospective study is to compare the clinical outcomes for patients who had arthroscopic Latarjet procedure with either double cortical buttons or two screws.Methods:20 patients who were treated with an arthroscopic Latarjet procedure between January 2019 and December 2021 were reviewed.The first group was treated with double cortical button and the second had two-screw fixation.The minimum follow-up was 9 months.Data such as age,number of previous dislocations,postoperative complications,range of movement,functional scores(American Shoulder and Elbow Society Score–ASES)and recurrence rate have been collected and studied.Healing rates of the transferred coracoid was also examined.Results:Mean age for the first group was 22.3 years and for the second 21.8 years.The mean follow-up was 21.2 months (range 9-44 months)for all the patients.No patient developed any complications or recurrence of their symptoms. The ASES score of the first group was improved from 67.2 preoperatively to 90.2 postoperatively and the second group from 68.5 to 91.4.The range of movement in all planes preoperatively was similar in both groups and was only marginally improved. External rotation postoperatively was reduced in both groups.The suture-button group had active external rotation of 77 degrees preoperatively and 72.3 degrees postoperatively.Similarly,the screws group had reduced external rotation from 73.2 degrees to 69.4 degrees.Bone union was evident in all patients.Conclusions:Our study is limited by the small sample size and the short follow up.It has the benefit of reviewing the results of a single surgeon.It has suggested that both techniques are of great value and may offer outstanding clinical outcomes with low complication rate.

Aim: The current study was conducted to investigate the functional outcomes of augmentation of in-situ superior capsular reconstruction-reinforced partial rotator cuff repair with middle trapezius tendon transfer for management of irreparable postero-superior cuff tears.
Patients & Methods: This prospective cohort study included 24 patients (with irreparable postero-superior rotator cuff tears) allocated into 2 consecutive groups; group-(A) of 2-layer tendon construct (in-situ superior capsular reconstruction-reinforced partial rotator cuff repair) included 15 patients; and group-(B) of 3-layer tendon construct (middle trapezius tendon transfer-augmented in-situ superior capsular reconstruction-reinforced partial rotator cuff repair) included 9 patients. Outcome measurements included 2-year postoperative pain rated according to Visual Analogue Scale (VAS) score; range of forward flexion and external rotation; and the American Shoulder and Elbow Surgeons (ASES) and the Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores.
Results: Statistically, studied groups were matched in terms of demographics, and preoperative evaluation data (P-value>0.05). Studied groups showed significant postoperative improvement in outcome measurements (P-value<0.05); however, this improvement was significantly higher in group-(B) (P-value<0.05).
Conclusion: Augmentation of in-situ superior capsular reconstruction-reinforced partial rotator cuff repair with middle trapezius tendon transfer (in a 3-layer tendon construct); for management of irreparable postero-superior rotator cuff tears; can significantly add more improvement in postoperative outcome measurements. However, further studies are still needed to validate this technical concept of 3-layer tendon construct.

Aim: The study investigated short-term functional outcomes of concurrent arthroscopic suture anchor-capsular plication and Intra-articular Soft Arthroscopic Latarjet Technique/in-SALT (i.e., arthroscopic soft-tissue biceps tenodesis to upper subscapularis using simple stitches) for management of anterior gleno-humeral micro-instability as a result of type-II SLAP lesion in overhead manual workers.
Patients & Methods: This prospective cohort study included 25 overhead manual workers with concurrent (1) Long-standing (i.e., >5 years) manual overhead work, (2) anterior gleno-humeral micro-instability, and (3) arthroscopic diagnosis of type-II SLAP lesion in concomitance with lax capsule and hypermobile medially-reflected antero-inferior labrum. Included patients were allocated into 2 concurrent groups; group-(A) of 14 patients managed with in-SALT and arthroscopic suture-anchor capsular plication; and group-(B) of 11 patients managed with in-SALT and arthroscopic capsular plication using free sutures. Outcome measurements included 2-year postoperative pain, range of motion and the ASES and Rowe Instability scores.
Results: In both groups, statistical analysis showed significant 2-year postoperative improvement in outcome measurements (P-value<0.05). However, postoperative functional improvement was relatively greater in group-(A). likewise, in group-(A); 11 (78.5%) patients have returned to pre-injury level of overhead activity compared with 7 (63.6%) patients in group-(B).
Conclusion: For management of anterior gleno-humeral micro-instability as a result of type-II SLAP lesion, in overhead workers, concurrent arthroscopic capsular plication and in-SALT can yield significant 2-year postoperative improvement in outcome measurements. However, use of suture anchors for capsular plication might offer higher functional scores and a better rate of return to pre-injury level of overhead activity compared with use of free sutures.

Aim: The study investigated short-term functional outcomes of concurrent arthroscopic capsular plication and Intra-articular Soft Arthroscopic Latarjet Technique/in-SALT (i.e., arthroscopic soft-tissue biceps tenodesis to upper subscapularis using simple stitches) for management of anterior gleno-humeral micro-instability, in over-stressed hypermobile female shoulder complicated with type-II SLAP lesion.
Patients & Methods: This prospective cohort study included 21 overhead manual female workers with concurrent (1) generalized joint laxity, (2) clinical diagnosis of anterior gleno-humeral micro-instability, and (3) arthroscopic diagnosis of type-II SLAP lesion in concurrence with lax attenuated capsule and hypo-plastic hypermobile medially-reflected antero-inferior labrum. Included patients were allocated into 2 concurrent groups; group-(A) of 12 patients managed with in-SALT coupled with arthroscopic suture-anchor capsular plication; and group-(B) of 9 patients managed with in-SALT coupled with arthroscopic capsular plication using free sutures. Outcome measurements included 2-year postoperative pain, range of motion and ASES and Rowe Instability scores.
Results: In both groups, statistical analysis showed significant 2-year postoperative improvement in outcome measurements (P-value<0.05). However, postoperative functional improvement was relatively greater in group-(A); likewise, in group-(A); 10 (83.3%) patients have returned to pre-injury level of activity compared with 7 (77.7%) patients in group-(B).
Conclusion: For management of anterior gleno-humeral micro-instability, in over-stressed hypermobile female shoulder complicated with type-II SLAP lesion, concurrent arthroscopic capsular plication and sin-SALT can yield significant 2-year postoperative improvement in outcome measurements. However, use of suture anchors for capsular plication might offer higher functional scores and a better rate of return to pre-injury level of activity in comparison with use of free sutures.

Introduction: The most common secondary shoulder deformity with obstetric brachial plexus palsy is the defective abduction and external rotation. This study aimed to evaluate arthroscopic subscapularis release as a treatment option for internal rotation shoulder contracture associated with OBPP. Patient and Methods: This prospective study was conducted over seven years (between 2012 and 2018), and included 28 patients who were presented with shoulder internal rotation contracture secondary to obstetric palsy before the age of 6 years with passive external rotation less than 10°. They were treated with shoulder arthroscopy to release the subscapularis tendon without any tendon transfer. The average age was 3 years (2 – 5 years). Twenty-two children had an injury at C5 C6, four had an injury at C5 C6 C7 and two had a complete injury. The average follow-up was 27 months (24 - 36 months). Results: At the latest follow-up, passive ER was 70° on average (40° - 90°) and active ER was 60° (20° - 90°). The mean global Mallet score improved from 11.29 ± 1.06 SD (range from 10 to 13) preoperatively to 17.38 ± 2.14 SD (range from 13 to 20) postoperatively. There were no intraoperative or postoperative complications. Conclusion: Arthroscopic Subscapularis Release for internal rotation contracture in OBPP is a minimally invasive procedure and shows promising results in the younger age groups.