Arthroscopic findings in atraumatic shoulder instability.
OBJECTIVE
The goal of this study was to evaluate the intra-articular pathology in patients with atraumatic shoulder instability who did not respond to conservative treatment.


METHODS
Prospective case series.


METHODS
Of 226 patients treated for shoulder instability over a 2-year-period, 43 patients (average age, 27.5 years; 26 men and 17 women) were classified as having atraumatic instability. None had responded to physiotherapy. The intra-articular pathology was documented during diagnostic arthroscopy before the definitive surgical procedure.


RESULTS
Three types of lesions of the capsulolabral complex were defined: incomplete labral lesions, pathologic elongation of the capsule or "non-Bankart lesions" (type I), classic Bankart lesions (type II), and complex lesions of the labrum and capsule (type III). Type I was found in 19 patients (44.2%); type II lesions were seen in 13 (30.2%); and type III in 11 (25.6%) patients. Hill-Sachs lesions were found in 26 shoulders (60.5%). Chondral lesions of the glenoid were seen in 10 shoulders (23%); SLAP lesions in 5 (11.7%); and partial, articular-side defects of the supraspinatus tendon in 3 (6.9%) patients.


CONCLUSIONS
Atraumatic onset of shoulder instability does not imply the absence of intra-articular lesions, at least in patients not showing a response to physiotherapy. Arthroscopy is helpful to diagnose the definite intra-articular pathology.


METHODS
Level IV.
Werner
Andreas W
AW
Department of Orthopaedics, University of Duesseldorf, Duesseldorf, Germany. werner@med.uni-duesseldorf.de
Lichtenberg
Sven
S
Schmitz
Helge
H
Nikolic
Ariane
A
Habermeyer
Peter
P
D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008297:Male; D011446:Prospective Studies; D012783:Shoulder Dislocation / Q000145:classification / Q000473:pathology* / Q000601:surgery; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology* / Q000601:surgery