[Sensorimotor deficit after capsulolabral reconstruction in chronic instability of the shoulder. A clinical experimental study].
The anterior capsulolabral reconstruction technique described by Jobe is a modified Bankart repair. The capsular shift is performed in a horizontal direction via a subscapularis split approach avoiding any incision of the muscle. Of 43 patients with posttraumatic anterior shoulder instability treated by anterior capsulolabral reconstruction, 35 were examined after 3.7+/-1.4 years, and of these, 29 (82.9%) had no pain; the external rotation deficit was 4.1+/-2.9 degrees . The average Constant-Murley score was 92.4+/-7.1 and the average ASES score was 93.3+/-8.4. The reluxation rate was 7.7%. This technique was shown to provide good clinical results, but only 69% of the patients were able to return to their prior sporting activity level. This particular problem was addressed by investigating the joint proprioception and the activity of the periarticular muscles. The results confirmed a persistent deficit of proprioception as well as a pathologic EMG pattern after anterior capsulolabral reconstruction, which may explain the problem of incomplete restoration of the function of the shoulder joint.
Fremerey
R
R
Unfallchirurgische Klinik, Klinikum Hildesheim. reinhardfremerey@t-online.de
Freitag
N
N
Bosch
U
U
Lobenhoffer
P
P
Wippermann
B
B
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000601:surgery; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D004576:Electromyography; D005260:Female; D006801:Humans; D006811:Humerus / Q000601:surgery; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures; D011434:Proprioception / Q000502:physiology; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D012783:Shoulder Dislocation / Q000150:complications; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome