مرکز منطقه ای اطلاع رساني علوم و فناوري - Arthroscopic treatment of anterior-inferior shoulder instability

Latin Abstract :

Objectives: We evaluated patients who underwent arthro¬scopic repair for posttraumatic, recurrent anterior-inferior glenohumeral instability with capsular laxity. Methods: Seventeen patients (4 females, 13 males; mean age 27 years; range 18 to 40 years) were treated with arthro- scopic Bankart repair and posterior capsular plication for posttraumatic, recurrent anterior-inferior glenohumeral instability with capsular laxity. Involvement was on the right side in 11 patients, and on the left in six patients. The mean duration from the first dislocation to surgery was 5.2 years (range 1 to 11 years). All the patients received con¬servative treatment before surgery. Range of motion was measured with a goniometer and muscle strength was mea¬sured manually. Apprehension test, Jobe apprehension-relo¬cation test, and posterior apprehension test were used to assess instability. Preoperatively, all the patients were exam¬ined by anteroposterior and axillary radiographs and mag¬netic resonance imaging. Shoulder functions were assessed with the Rowe rating scale for Bankart repairs. The mean follow-up was 35.6 months (range 24 to 50 months). Results: Instability recurred in three patients (17.7%). The Rowe score increased from a mean of 41 (range 15¬45) to 78 (range 43-100) postoperatively. Functional results were excellent-good in 13 patients (76.5%), fair in one patient (5.9%), and poor in three patients (17.7%). One patient underwent arthroscopic revision following redislocation. Pre- and postoperative values for active for¬ward flexion, external rotation, and internal rotation did not differ significantly (p>0.05). Conc l u s i o n : The results of arthroscopic Bankart repair and posterior capsular plication are satisfactory in the treatment of anterior glenohumeral instability with capsular laxity. However, the use of capsular plication with arthroscopic Bankart repair should be considered in selected cases.