An All-Arthroscopic Solution of Shoulder Instability for Professional and Active Individuals

Chinese Unique Inlay Bristow (Cuistow Surgery) Using Suture Button Fixation – An All-Arthroscopic Solution for Professional and Active Individuals

 

Summary

 

The shoulder joint is one of the most mobile joints in the human body, but its stability is relatively poor. Consequently, the incidence of dislocation is significantly higher than that of other joints, accounting for more than 40% of all joint dislocations, and it is especially common among young, active individuals. Anterior dislocation is the most frequent type of shoulder dislocation, often resulting in structural damage that predisposes the joint to recurrent dislocation with minor trauma, a condition known as “anterior shoulder instability.” When conservative treatment for anterior shoulder instability yields unsatisfactory results, surgical intervention is generally indicated. The coracoid transfer procedure is one of the commonly performed surgeries, particularly suitable for patients with relatively large glenoid bone defects and those with high functional or athletic demands. By transferring the coracoid process together with the conjoint tendon to the anterior inferior glenoid, the procedure provides both a bony and a soft tissue block to prevent recurrent anterior instability. Depending on the placement of the bone block, the procedure is classified as either the Bristow or the Latarjet procedure.

 

Traditionally, the coracoid graft has been fixed with screws. However, this approach is associated with a series of problems, including incomplete bone healing, graft resorption, graft fracture, screw loosening or breakage, and complications related to impingement with the humeral head. To address these issues, Boileau et al. introduced the use of a suture-button device for coracoid transfer, a technique referred to as “elastic fixation” in contrast to the rigid metallic fixation provided by screws. In subsequent studies, Boileau and his team reported a bone union rate of 91% for the Latarjet procedure using elastic fixation, compared to only 74% for the Bristow procedure. To improve the bone union rate of the traditional Bristow procedure, Professor Guoqing Cui’s research group incorporated the Inlay mortise-tenon structure, inspired by traditional Chinese architecture, into the Bristow procedure. They named this technique the “Chinese unique Inlay Bristow (Cuistow surgery) using suture button fixation.” Mid-term follow-up results have confirmed its reliability and superiority. The intraoperative creation of this Inlay structure increases the contact area between the transferred graft and the glenoid, thereby enhancing postoperative graft healing—a finding of particular clinical significance when elastic fixation is used.

 

Cuistow Surgery Using Suture Button Fixation – All-Arthroscopic Inlay Coracoid Transfer at AMCare, Beijing, China

 

Regain shoulder stability, return to the sports you love, and experience a world-class surgical solution with our exclusive shoulder instability package at AMCare – Orthopedic & Sports Medicine in Beijing. Designed specifically for professional athletes and active individuals, this package features the all-arthroscopic Chinese Unique Inlay Bristow (Cuistow surgery) using suture button fixation—a procedure that combines the reliability of the Inlay concept with the safety of metal‑free elastic fixation. If recurrent shoulder dislocation has limited your athletic performance, caused chronic pain, or prevented you from confidently engaging in high‑demand sports, this advanced approach offers a definitive pathway to recovery.

 

Choosing AMCare in Beijing means entrusting your shoulder to a premier institution specializing in complex arthroscopic and reconstructive procedures for athletes. Our facility combines cutting‑edge technology with advanced surgical techniques to maximize graft healing, restore stability, and facilitate a rapid, safe return to sport. For a comprehensive, transparent price, you receive not only a state‑of‑the‑art surgical procedure but also a complete care plan—from initial consultation through surgery and structured rehabilitation—ensuring a seamless and successful medical journey in the heart of China.

 

Why Choose AMCare for Your Anterior Shoulder Instability Treatment as a Professional or Active Individual?

 

1.         Access a Comprehensive Shoulder Instability Package in Beijing for the all-arthroscopic Cuistow surgery using suture button fixation at a fixed, transparent price.

2.         Receive Treatment at AMCare – Orthopedic & Sports Medicine, a leading facility specializing in complex shoulder reconstruction and sports injury management. Prof. Guoqing CUI is the pioneer of the Cuistow procedure, with extensive experience in treating elite athletes and patients with significant glenoid bone loss.

3.         Benefit from an Innovative, Athlete‑Focused Surgical Solution that combines the traditional Bristow procedure with an Inlay (mortise‑tenon) structure, dramatically increasing graft‑to‑glenoid contact area, promoting superior bone healing, and avoiding metal screw‑related complications—critical advantages for those who demand long‑term shoulder health and high‑level performance.

4.         Receive Treatment Personally Performed by Prof. Guoqing Cui, the creator of the Cuistow procedure. Prof. Cui has successfully performed this surgery on dozens of athletes from the Chinese National Team and served as a team physician at the recently concluded Milan Winter Olympics, where the athletes under his care won multiple Olympic gold medals.

5.         Benefit from Elite-Level Rehabilitation Guidance under the direct supervision of Prof. Cui, delivered by a gold medal physiotherapist appointed by the General Administration of Sport of China. This rehabilitation specialist has provided care for numerous current and retired members of the Chinese National Olympic Team, ensuring that your preoperative preparation and postoperative recovery follow the same protocols used by world-class athletes.

6.         Combine Your Treatment with a Recovery in Beijing, China, a vibrant cultural hub, while receiving world‑class postoperative care and structured rehabilitation tailored to athletes.

 

Unpacking the Cost of Cuistow Surgery Using Suture Button Fixation at AMCare, Beijing

 

We believe in transparent, affordable access to superior surgical care. Our all‑inclusive shoulder instability package at AMCare is priced to deliver unparalleled value, combining the expertise of a pioneering surgeon with advanced arthroscopic technology. This approach allows you to budget with confidence, avoiding the hidden fees often associated with complex shoulder surgery in other countries. The table below illustrates the significant savings you can achieve by choosing our facility in Beijing.

 

Note: Price may vary depending on the complexity of the procedure and the patient’s specific medical condition. The package covers the complete treatment, including the arthroscopic procedure, implant materials, and all in‑hospital care.

 

What’s Included in the Cuistow Surgery Using Suture Button Fixation Package?

 

-       Comprehensive preoperative consultations and diagnostic imaging (shoulder X‑rays, 3D CT with glenoid bone loss assessment, MRI, and preoperative blood work).

-       Surgeon, anesthesiologist, and full surgical team fees, including a dedicated shoulder and sports medicine specialist.

-       All costs related to the all‑arthroscopic Cuistow procedure with suture button fixation, including:

-       Arthroscopic graft harvesting and preparation.

-       Creation of the Inlay bone slot (mortise) in the glenoid.

-       Coracoid graft transfer and suture button fixation with additional high‑strength suture reinforcement.

-       Capsular and labral repair (if indicated) using suture anchors for enhanced stability.

-       Hospital stay in a private room (typically 1–2 nights post‑surgery).

-       Prescribed medications and multimodal pain management during your hospital stay.

-       Initial postoperative physical therapy and rehabilitation consultation.

-       All necessary surgical implants, including the suture button device, high‑strength sutures, and any required suture anchors.

-       Follow‑up consultations with Prof. Cui before discharge, including final imaging to confirm graft positioning and healing.

-       Detailed home exercise program and sport‑specific return‑to‑play protocol.

 

What’s Not Included in the Cuistow Package?

 

-       International airfare to and from Beijing, China.

-       Costs associated with visa application and processing.

-       Accommodation for you or any companions outside of the hospital stay.

-       Daily meals and personal expenses (meals for the patient are typically provided during hospitalization).

-       International travel and medical complications insurance.

-       Extended outpatient physical therapy or rehabilitation beyond the initial postoperative consultation.

 

A Deeper Look into Cuistow Surgery Using Suture Button Fixation – An Athlete‑Centered Innovation

 

The Chinese Unique Inlay Bristow (Cuistow surgery) using suture button fixation represents a significant advancement in the surgical management of anterior shoulder instability, particularly for patients with glenoid bone loss and high athletic demands. This innovative technique addresses the limitations of traditional coracoid transfer procedures—namely, graft nonunion and metal screw‑related complications—by incorporating an Inlay (mortise‑tenon) structure inspired by traditional Chinese architecture, combined with modern elastic fixation using a suture button device.

 

1. Origins and Development of Elastic Fixation

 

1.1. Limitations of Traditional Screw Fixation

 

In traditional coracoid transfer procedures, the transferred coracoid graft is most often fixed with screws. The biomechanical stability and clinical outcomes of screw fixation are well established. However, being metallic implants, screws can give rise to a range of related complications. A systematic review by Butt et al. found that the most common complications after coracoid transfer surgery were directly or indirectly caused by screws; analyzing 30 studies involving 1,658 patients, the incidence of screw‑related complications was 6.5%. The limitations and complications associated with screw fixation can be summarized as follows: ① Excessive postoperative shoulder activity may lead to screw problems such as bending, breakage, loosening, or migration—a risk that is particularly pronounced in professional athletes. ② During surgery, it is difficult to precisely control the length and depth of screw placement. Screws that are too long may injure nerves or irritate adjacent soft tissues, while screws that are too short may provide inadequate fixation, leading to graft nonunion or even postoperative graft displacement. In the study by Butt et al., the average rate of graft nonunion or displacement after screw‑fixed coracoid transfer was 10.1%. ③ Arthroscopic coracoid transfer is being increasingly used, but accurate screw placement and implantation under arthroscopy are technically challenging and prone to suboptimal screw positioning.

 

1.2. Origins, Development, and Advantages of Elastic Fixation

 

To address the shortcomings of traditional screw fixation, Boileau et al. introduced an elastic fixation technique using a suture‑button device in 2012. In a 6‑month follow‑up of patients undergoing the Latarjet procedure with elastic fixation, they found a bone union rate of 91%, comparable to that historically reported for screw fixation, with more accurate graft positioning and avoidance of screw‑related complications. In 2019, the same group reported outcomes in 121 patients with anterior shoulder instability who underwent the Latarjet procedure with elastic fixation, with a minimum follow‑up of 2 years. The bone union rate was 95%, the postoperative recurrence rate was 3%, and 93% of patients returned to sports. Xu et al. reported 3‑year follow‑up results after the Latarjet procedure with elastic fixation, demonstrating satisfactory clinical outcomes and, based on postoperative CT assessment, good glenoid remodeling. Shao et al. reported outcomes after all‑arthroscopic Latarjet with elastic fixation, showing that at 3 years postoperatively all patients achieved clinical score improvements exceeding the minimal clinically important difference, with a graft union rate of 96.7%. In terms of biomechanics, several studies have shown no significant difference in biomechanical strength between elastic fixation and screw fixation for coracoid transfer. Thus, the biomechanical stability and clinical efficacy of elastic fixation have been preliminarily established, and its use in coracoid transfer can avoid the complications associated with screws—an advantage of particular importance for athletes who require a reliable, metal‑free construct.

 

1.3. Limitations of Elastic Fixation

 

Compared with screw fixation for coracoid transfer, some authors have noted certain drawbacks of elastic fixation regarding graft union rates and postoperative shoulder stability. In 2021, Bonnevialle et al. conducted a comparative study showing that elastic fixation resulted in a longer graft union time than screw fixation; on CT evaluation at 3 months postoperatively, the bone union rate was only 41% in the elastic fixation group, whereas the screw‑fixed grafts had fully healed. A multicenter comparative study including 308 patients who underwent the Latarjet procedure (236 with screw fixation, 72 with elastic fixation) reported that after a minimum follow‑up of 2 years, the recurrence rate of shoulder instability was higher in the elastic fixation group than in the screw fixation group (8.3% vs. 2.5%, P = 0.02). However, 5.9% of patients in the screw fixation group required reoperation, 57.2% of which were related to screw complications, whereas no patient in the elastic fixation group underwent reoperation due to complications. A 2023 systematic review indicated that, compared with elastic fixation, screw fixation in the Latarjet procedure reduces the risk of postoperative recurrent dislocation, although some patients may require subsequent screw removal due to hardware‑related complications. Similarly, a meta‑analysis including five clinical comparative studies showed that the dislocation recurrence rate was significantly higher with elastic fixation than with screw fixation (5.8% vs. 1.6%; OR = 0.240, P = 0.001). Most clinical studies comparing the two fixation methods are retrospective with relatively low levels of evidence; further high‑quality studies with longer follow‑up are needed to fully evaluate their relative merits.

 

1.4. Differences in Outcomes Based on Elastic Fixation Techniques

 

For coracoid transfer, several elastic fixation techniques currently exist, including the use of one suture button or two, and whether a tensioner is used during knot tying. In 2022, Boileau et al. compared the outcomes of knot tying with versus without a tensioner in elastic fixation. Based on CT evaluation at 6 months postoperatively, the bone union rate was 74% (25/34) when manual knot tying was used, compared with 94% (33/35) when a tensioner was used, a statistically significant difference. Barret et al. investigated the association between the number of suture buttons used in the Latarjet procedure and clinical outcomes. They found that compared with using one suture button, the use of two suture buttons conferred no clinical advantage but increased surgical complexity, prolonging operating time by approximately 20 minutes.

 

2. The Cuistow Surgery Using Suture Button Fixation

 

2.1. Research Progress on the Cuistow Procedure

 

Classic coracoid transfer procedures are divided into the Bristow and Latarjet procedures based on the length and placement of the coracoid graft. Several studies have shown that compared with the Latarjet procedure, the Bristow procedure has a shorter operative time, causes less local structural disruption, and is associated with a higher rate of return to sports. However, the Bristow procedure relies on a single screw for fixation, and the contact area between the transferred coracoid and the glenoid is relatively smaller, resulting in a lower graft union rate than the Latarjet procedure. Moreover, multiple studies have confirmed that the key to success in coracoid transfer surgery is achieving bony union between the transferred graft and the glenoid, and that graft nonunion is a major cause of recurrent shoulder instability after the procedure.

 

To address the low bone union rate of the classic Bristow procedure, Professor Guoqing Cui’s team modified the traditional Bristow procedure by incorporating an Inlay mortise‑tenon structure inspired by traditional Chinese architecture. Using specialized instruments, they shape the base of the coracoid into a bone pillar and create a matching bone slot in the anterior inferior glenoid. This technique substantially increases the contact area and initial stability between the transferred coracoid and the glenoid, with the potential to improve the bone union rate of traditional coracoid transfer. They named this procedure the “Chinese Unique Inlay Bristow (Cuistow surgery) using suture button fixation.” Biomechanical testing by Gao et al. confirmed that the Cuistow procedure, based on the Inlay structure, provides higher initial biomechanical stability than classic coracoid transfer. In terms of clinical outcomes, analysis of 51 patients who underwent the Cuistow procedure with screw fixation showed a graft union rate of 92.1% at 3 months postoperatively and 96.4% at 1 year. At final follow‑up (mean 36.1 ± 3.7 months), all patients had returned to normal life with no recurrence of shoulder instability, and treatment results were satisfactory. Another study of 177 patients with athletic demands who underwent the Cuistow procedure with a minimum follow‑up of 2 years showed that 94.4% returned to sports, 86.6% returned to their pre‑injury level of sport, and only 2 patients experienced recurrent shoulder instability. These findings suggest that the Cuistow procedure offers superior biomechanical stability and bone union rates compared with the traditional Bristow procedure—outcomes that are especially critical for professional and active individuals aiming for a reliable return to high‑level activity.

 

2.2. The Cuistow Procedure with Suture Button Fixation

 

Compared with traditional metallic screw fixation, some studies have suggested that elastic fixation is associated with inferior graft bone healing, particularly in the Bristow procedure. Boileau et al. reported that in arthroscopic Bristow procedures using elastic fixation, the bone union rate at 6 months postoperatively was only 74%. Because the Cuistow procedure increases the contact area and initial stability between the graft and the glenoid, it holds promise for achieving higher bone union rates in patients receiving elastic fixation than does the elastic‑fixed Bristow procedure. A 3‑year follow‑up of 56 patients who underwent all‑arthroscopic Cuistow with suture button fixation showed a graft union rate of 96.4% at final follow‑up, substantially higher than that reported for the elastic‑fixed Bristow procedure. Furthermore, a study comparing screw fixation (63 patients) and suture button fixation (54 patients) in the Cuistow procedure with more than 2 years of follow‑up found that both fixation methods achieved high graft union rates (screw fixation 98.4%, suture button fixation 96.3%, P > 0.05). Both groups had satisfactory clinical outcomes, with only one patient (in the suture button fixation group) experiencing recurrent shoulder instability. However, the screw fixation group had worse outcomes in terms of graft resorption rate (47.6% vs. 18.5%) and implant‑related complication rate (7.9% vs. 0). Thus, the Cuistow procedure using suture button fixation may represent the ideal solution for athletes, combining the metal‑free safety of elastic fixation with bone healing outcomes that rival or exceed those of screw‑fixed alternatives.

 

Regarding whether the Cuistow procedure should be performed with screw or suture button fixation, both approaches are viable, and the choice depends on patient needs and the surgeon’s familiarity with the techniques. In our technical approach to suture button fixation, we differ from the technique reported by Boileau et al. in that we do not use a tensioner. Instead, we pass a high‑strength suture through the suture‑button device, which serves both as a traction suture during button tightening and can be tied after final fixation to further reinforce the stability of the suture‑button construct. Additionally, in cases using suture‑button fixation, the tied sutures can be used to plicate the anterior capsule and labrum and then anchored with an all‑suture anchor at the 3‑o’clock or 5‑o’clock position on the glenoid. This technique further enhances graft stability while allowing the graft to be positioned extracapsularly. For the Cuistow procedure, the glenoid bone slot is typically prepared with a diameter of 10 mm and a depth of 7 mm for screw fixation; correspondingly, the coracoid root is shaped into a bone pillar measuring 10 mm × 7 mm. For the Cuistow procedure with suture button fixation, we consider that if preoperative assessment shows the coracoid to be sufficiently long (>17 mm) and the glenoid bone defect relatively small (<15%), the length of the bone slot and bone pillar can be increased to 9 mm to further enhance graft stability and bone union with elastic fixation—a refinement that can be particularly beneficial for athletes who demand the highest level of shoulder performance.

 

3. Summary and Future Perspectives

 

Suture button fixation (elastic fixation) is a novel approach for coracoid transfer that avoids the metal implant‑related complications associated with traditional screw fixation. Its biomechanical stability and clinical efficacy have been preliminarily validated, although debate continues regarding its bone union rates and postoperative recurrence compared with traditional screw fixation. The Cuistow surgery using suture button fixation represents a solution to improving bone union rates when elastic fixation is used. As a Chinese innovation in coracoid transfer, this procedure has demonstrated biomechanical stability and clinical advantages that are supported by preliminary evidence, with particularly promising outcomes for athletes and active individuals. However, current clinical studies have relatively short follow‑up periods, and longer‑term follow‑up is required to confirm its durability and long‑term clinical outcomes.

 

Core Principles of Cuistow Surgery Using Suture Button Fixation:

 

-       Enhanced Graft Healing (The Inlay Concept): Unlike the classic Bristow procedure, where the coracoid graft is simply placed on the glenoid surface (onlay), the Cuistow procedure creates a precisely shaped bone slot (mortise) in the glenoid neck. The coracoid graft is then shaped into a matching tenon (bone pillar) that fits *into* the slot. This increases the graft‑to‑glenoid contact area by up to 300%, providing exceptional initial stability and creating an ideal environment for rapid, robust bone healing—a key factor for athletes who require early, safe rehabilitation.

 

-       Suture Button Fixation to Avoid Metal Complications: Instead of traditional metal screws, this technique uses a suture‑button device (elastic fixation). This eliminates the risks associated with metal implants, such as screw loosening, breakage, hardware impingement with the humeral head, and the need for subsequent hardware removal—a critical advantage for athletes and active individuals who want to avoid a second surgery for hardware removal.

 

-       Biomechanical Superiority: Biomechanical studies have confirmed that the Inlay structure of the Cuistow procedure provides significantly higher initial stability compared to the classic Bristow procedure. When combined with suture button fixation, it offers a construct that is both stable enough to protect the graft during early healing and flexible enough to avoid stress shielding, promoting superior bone remodeling.

 

-       Combined Soft Tissue Restoration: In addition to the bone block transfer, the procedure often incorporates capsular and labral repair using suture anchors. The high‑strength suture from the suture‑button device can also be used to imbricate the capsule, further enhancing stability and allowing the graft to be positioned extracapsularly, more closely replicating normal anatomy—a refinement that supports the high‑demand activities of athletes.

 

Why Cuistow with Suture Button Fixation Is the Ideal Choice for Athletes:

 

Traditional Bristow and Latarjet procedures, while effective, have limitations. Screw fixation, the historical standard, carries a 6–10% complication rate, including hardware failure and graft nonunion. Elastic fixation was developed to avoid these metal‑related issues, but early studies showed lower bone union rates (as low as 74%) with the classic Bristow procedure. The Cuistow procedure was specifically designed to overcome this challenge. By creating the Inlay bone interface, it transforms the elastic‑fixed Bristow into a procedure with bone healing rates exceeding 96%—comparable to or better than screw‑fixed alternatives—while completely eliminating metal‑related complications. For professional athletes and active individuals, this means a safer, more reliable return to sport without the worry of hardware failure or the need for additional surgery.

 

The AMCare Advantage for Your Shoulder Instability Surgery in Beijing

 

-       State‑of‑the‑Art Arthroscopic Facility: Our hospital is equipped with the latest arthroscopic technology, including high‑definition 4K visualization systems, advanced radiofrequency devices, and dedicated shoulder arthroscopy instrumentation, ensuring precision and safety throughout the procedure.

-       Pioneering Surgeon with a Focus on Athletes: The Cuistow surgery using suture button fixation was developed by Prof. Guoqing CUI, who leads our shoulder surgery team. With decades of experience in treating elite athletes and complex shoulder instability cases, Prof. Cui offers unparalleled expertise in this advanced technique, ensuring that your treatment plan is tailored to your sport‑specific demands.

-       Comprehensive Patient Support: We provide dedicated support for our international patients, including English‑speaking case managers, clear communication throughout your treatment journey, and assistance with travel logistics.

-       Structured Rehabilitation Focus: We integrate early rehabilitation planning into your treatment, providing detailed, sport‑specific protocols to ensure a safe and efficient return to your sport. Under the direct supervision of Prof. Cui, a gold medal physiotherapist appointed by the General Administration of Sport of China leads all preoperative preparation and postoperative recovery, applying the same elite-level protocols used for members of the Chinese National Olympic Team.

-       Proven Outcomes: Clinical studies on the Cuistow procedure have demonstrated a graft union rate of over 96%, a low recurrence rate of less than 2%, and a return‑to‑sport rate exceeding 94% for athletes.

 

Your Day‑by‑Day Guide to Cuistow Surgery Using Suture Button Fixation in Beijing

 

Your surgical journey is carefully structured to ensure a safe, comfortable, and effective experience over a planned stay of approximately 10–14 days.

 

-       Day 1: Arrival in Beijing. You will be greeted and transferred to your accommodation to rest and acclimate.

-       Day 2–3: Preoperative Days at AMCare. You will have your initial consultation with the shoulder surgery team, undergo comprehensive evaluations (shoulder X‑rays, 3D CT scan, MRI), and meet with your anesthesiologist.

-       Day 4: All‑Arthroscopic Cuistow Procedure with Suture Button Fixation. The surgery is performed under general anesthesia. The coracoid graft is harvested, the glenoid Inlay slot is prepared, and the graft is transferred and secured with a suture‑button device and high‑strength suture reinforcement. The capsule and labrum are repaired as needed.

-       Day 5–6: Postoperative Recovery. You remain in the hospital for pain management, wound care, and initial gentle range‑of‑motion exercises under the guidance of a physical therapist. You are fitted with a protective sling.

-       Day 7–10: Outpatient Care & Rehabilitation Consultation. You attend follow‑up appointments, including imaging to confirm graft positioning. You receive a detailed home exercise program and sport‑specific return‑to‑play protocol from your surgeon and rehabilitation team.

-       Day 11–14: Final Consultation & Clearance. You attend your final follow‑up with Prof. Cui, who provides a comprehensive discharge summary, wound clearance, and detailed instructions for ongoing recovery.

-       Day 14: Departure. You are free to travel home with a customized home exercise program and follow‑up instructions.

 

Achieving Stability: What to Expect After Your Cuistow Procedure

 

The primary outcome of your Cuistow surgery using suture button fixation will be the restoration of shoulder stability, allowing you to confidently return to sports and daily activities without the fear of recurrent dislocation. For athletes and active individuals, this translates to the ability to resume overhead, throwing, and contact sports with a significantly reduced risk of recurrence. The recovery journey follows a structured timeline designed to support your athletic goals:

 

-       0–6 weeks: Protected range of motion in a sling; gentle passive and active‑assisted exercises.

-       6–12 weeks: Progressive strengthening and weaning from the sling.

-       3–6 months: Advanced strengthening, sport‑specific drills, and gradual return to non‑contact activities.

-       6–12 months: Full return to contact and overhead sports, depending on healing and rehabilitation progress.

 

Patient satisfaction rates are exceptionally high, as the long‑term benefit of a stable, pain‑free shoulder with preserved motion is truly life‑changing for active individuals.

 

Discover the Benefits of Choosing Beijing, China for Your Shoulder Stabilization Surgery

 

-       Exceptional Affordability: Achieve savings of over 80% on advanced arthroscopic shoulder reconstruction compared to costs in the US, Canada, or Europe, without compromising on the quality of care or surgical expertise.

-       World‑Class Healthcare Infrastructure: China has invested heavily in its medical sector, and facilities like AMCare feature modern technology and adhere to strict international patient safety protocols.

-       Access to a Pioneer in the Field: Receive treatment from Prof. Guoqing CUI, the innovator of the Cuistow procedure, with extensive experience in managing complex instability cases in high‑demand athletes.

-       No Waiting Lists: Gain immediate access to the surgical procedure you need, avoiding lengthy wait times common in many national health systems.

-       A Cultural Hub: Your recovery period provides a unique opportunity to experience the rich history and attractions of Beijing, from the Forbidden City to the Great Wall, with appropriate medical clearance.

-       Seamless Travel Experience: As a major global city, Beijing is easily accessible with two large international airports and excellent infrastructure, making your travel smooth and convenient.

 

Your Questions Answered: Cuistow Surgery Using Suture Button Fixation in Beijing

 

1. How long do I need to stay in Beijing for the Cuistow procedure?

The total stay is typically 10–14 days. This includes preoperative consultations, the surgery itself, immediate postoperative recovery, and outpatient follow‑up appointments to ensure a safe and well‑managed discharge.

 

2. Is the Cuistow procedure painful?

The surgery is performed under general anesthesia, so you will not feel pain during the procedure. Postoperatively, you will have a nerve block and multimodal pain management to keep you comfortable. Most patients describe the pain as manageable, with significant relief within the first week.

 

3. What are the advantages of suture button fixation over screws for athletes?

Suture button fixation (elastic fixation) eliminates the risks associated with metal screws, such as hardware loosening, breakage, impingement with the humeral head, and the need for subsequent removal surgery. This is particularly beneficial for athletes, as it reduces the risk of long‑term complications and avoids a second surgery for hardware removal, allowing for a more straightforward return to sport.

 

4. How does the Cuistow procedure achieve such high bone healing rates?

The key is the Inlay (mortise‑tenon) structure. By creating a bone slot in the glenoid and shaping the coracoid graft to fit *into* it, the contact area between the graft and the glenoid is significantly increased. This provides exceptional initial stability and creates an optimal environment for rapid, robust bone healing—a critical factor for athletes who need to progress through rehabilitation on a predictable timeline.

 

5. Will I need a blood transfusion?

Blood loss during this all‑arthroscopic procedure is minimal, and transfusion is rarely, if ever, required.

 

6. How much correction or improvement can I expect?

The goal is to restore shoulder stability. In patients with significant glenoid bone loss, the Cuistow procedure effectively reconstructs the bony architecture of the glenoid, reducing the risk of recurrent dislocation to less than 2–5% in most series. Most patients experience a significant improvement in shoulder stability and function, allowing them to return to demanding sports activities.

 

7. When can I return to my sport?

Return‑to‑sport timelines depend on your specific injury, the procedure performed, and your commitment to rehabilitation. Generally, non‑contact sports can be resumed around 3–6 months, while contact and overhead sports are typically allowed at 6–12 months post‑surgery, following clearance from your surgeon. Our sport‑specific protocols are designed to help athletes return safely and confidently.

 

8. How do I handle communication if I don't speak Chinese?

AMCare is experienced in treating international patients. The clinic provides English‑speaking staff, Case Managers, and can arrange for interpreters to ensure clear communication with your medical team at all times.

 

9. Can a family member stay with me?

Yes, we encourage you to bring a companion for support. We can provide information on nearby accommodation options for your companion(s) during your stay.

 

10. What makes the AMCare shoulder instability package in Beijing so affordable?

The lower cost of living and operational expenses in China, combined with efficient healthcare management, allows us to offer world‑class medical services at a fraction of the price found in Western countries—without compromising on surgical expertise, technology, or patient safety.

 

11. Why choose Cuistow with suture button fixation over a standard Latarjet or Bristow?

Cuistow with suture button fixation combines the soft‑tissue advantage of the Bristow procedure (preserving the conjoint tendon and coracoacromial ligament) with superior bone healing rates through its unique Inlay design. When paired with suture button fixation, it offers the benefits of a metal‑free implant with bone healing outcomes that exceed traditional elastic‑fixed Bristow and rival screw‑fixed Latarjet procedures. For professional athletes and active individuals who require reliable stability, rapid bone healing, and avoidance of hardware‑related complications, this procedure represents an ideal solution.