Shoulder function after arthroscopic anterior stabilization of the glenohumeral joint using an absorbable tac.
Among the advantages of arthroscopic stabilization could be less loss of range of motion and, with that, better functional outcome. In each of 24 shoulders, arthroscopic anterior repair of instability was performed through use of cannulated resorbable tacs (Suretacs), and the clinical outcome, especially the function, was examined in 20 shoulders after a mean follow-up of 3.4 years. The study included a retrospective analysis of 10 shoulders with documented recurrent anterior dislocations, 3 shoulders with posttraumatic subluxations, and 7 shoulders with painful apprehension and unequivocally clear Bankart lesions at arthroscopy. The evaluation of the recurrent dislocators revealed recurrence in 20%, residual instability in 10%, and a mean loss of external rotation of 28.5 degrees. No recurrence or residual instability was encountered in the other 2 groups. Mean loss of external rotation was 15 degrees in the group of subluxators and 20 degrees in the group of painful shoulders with intraoperatively evident instability. Through use of the Rowe score, failure was found in 30% of the dislocators; no failures were noted in the other groups. The painful shoulders with intraoperatively evident instability had significantly (P < .05) better Rowe scores than shoulders that had documented dislocation. Our series confirmed a relatively high failure rate for arthroscopic anterior stabilization of recurrent anterior dislocators. Our series did not confirm that arthroscopically successfully stabilized shoulders recover full function and mobility. In the light of the relatively high rate of residual instability and incomplete functional recovery in successfully stabilized shoulders, we have discontinued use of this technique for the treatment of recurrent dislocators.
Dora
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Department of Orthopaedics, University of Zürich, Balgrist Hospital, Switzerland.
Gerber
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D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome