title: Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years.
abstract: OBJECTIVE
  To report our experience with the arthroscopic treatment of patients aged 40 to 60 years with rotator cuff lesions, shoulder instability, or both, and to seek a relationship among capsular-labral complex lesions, cuff tears, number of dislocations, and patient age.
  
  
  METHODS
  Case series.
  
  
  METHODS
  From January 2000, all patients aged between 40 and 60 years undergoing an arthroscopic procedure for rotator cuff lesions, shoulder instability, or both were divided into 3 cohorts: shoulder instability (group I), complete cuff tear (group C), and instability and complete cuff tear (group IC). In May 2002 there were 50 patients per group. Arthroscopic findings were analyzed using the Pearson correlation coefficient and the chi2 test to seek correlations between the lesions. The Student t test was used to highlight significant differences between preoperative and postoperative scores.
  
  
  RESULTS
  There was a strong correlation between the rising number of dislocations and associated lesions of the supraspinatus and infraspinatus (P < .001); this correlation became stronger after 7 episodes of dislocation (P < .0001). There was no correlation between capsular or Bankart lesion and presence or absence of rotator cuff tears (P > .5). Two cases of recurrence of instability were recorded in group IC. Postoperatively, the Constant and Rowe scores rose significantly and consistently in all patients (P < .001).
  
  
  CONCLUSIONS
  Rotator cuff tears and glenohumeral instability appear to be closely related. Patient age and number of dislocations do not appear to correlate with Bankart or capsular lesions, whereas posterosuperior cuff tears seem to be influenced by number of dislocations. Although data do not permit us to conclude whether repair of the sole cuff tear can achieve shoulder stability nor whether shoulder stabilization alone can resolve the instability, treatment of both lesions should be performed arthroscopically.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Cattolica, Italy. gporcellini@tin.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Porcellini
authors.forename: Paolo
authors.initials: P
authors.lastname: Paladini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Campi
authors.forename: Massimo
authors.initials: M
authors.lastname: Paganelli
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000293:injuries; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D012783:Shoulder Dislocation / Q000601:surgery*; D016896:Treatment Outcome