Postoperative functional outcome and stability in recurrent traumatic anteroinferior glenohumeral instability: comparison of two different surgical capsular reconstruction techniques.
BACKGROUND
Patients (n=62) with recurrent traumatic anterior or anteroinferior glenohumeral instability were prospectively evaluated with reference to the surgical reconstruction technique performed.


METHODS
Neer's T-plasty procedure was performed in group I (n=31) while a modified, anatomically orientated, anteroinferior capsular shift was performed in group II (n=31). All patients underwent an additional Bankart repair. After 18.1 (group II) and 22.2 (group I) months, patients were assessed in terms of subjective satisfaction, objective stability, range of motion, and functional outcome.


RESULTS
No significant differences (91.5% group II, 87.8% group I) were noted between the study groups regarding the patient's subjective evaluation (p=0.17106). Results of Rowe's (93.1% group II, 87.9% group I; p=0.14419) and Constant's Score (96.5% group II, 93.8% group I; p=0.16582) showed no significant differences for both collectives. Postoperative lack of external rotation remained significantly smaller in group II (5.6 degrees +/-2.5 degrees ) compared with group I (9.8 degrees +/-2.5; p=0.00028). Although no significant differences (p=0.612) were found, the rate of recurrence was obviously smaller in group II (group II vs group I: 6 patients).


CONCLUSIONS
Our results demonstrate no significant differences between the two capsular reconstruction techniques regarding patient's satisfaction, Rowe and Constant Scores. However, the anatomically orientated anteroinferior capsular shift leads to a significantly smaller external rotation deficit and seems to offer a more reliable postoperative stability.
Jaeger
Alwin
A
Department of Orthopaedic and Trauma Surgery, Orthopädische Universitätsklinik und Poliklinik Friedrichsheim, Frankfurt am Main, Germany. Alwin.Jaeger@t-online.de
Braune
Carsten
C
Welsch
Frederic
F
Sarikaya
Yusuf
Y
Graichen
Heiko
H
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012008:Recurrence; D012783:Shoulder Dislocation / Q000209:etiology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome