[Arthroscopic treatment of posterior shoulder instability: technique and results].
Posterior shoulder instability occurs in approximately 2-5% of all cases of shoulder instability and treatment is still challenging. Open capsular plication procedures are described, but significant complications and risks have been reported in the literature. Arthroscopy has led to a better understanding of the pathoanatomy of posterior shoulder instability in recent years. We present our operative technique and the results of arthroscopic posterior shoulder stabilisation for the management of posterior shoulder instability. Sixteen patients with posterior shoulder instability were treated by arthroscopic posterior stabilisation from January 2004 to March 2005. There were 11 male and 5 female patients. The mean age was 24 (15-45) years. Nine patients had a unidirectional posterior instability. Seven patients had a predominantly posterior instability based on a multidirectional instability. Fourteen patients were evaluated after a mean follow-up of 12 (6-18) and 20 (14-26) months. Stability, range of motion and function were assessed using the Rowe score. The average Rowe score improved from pre-operative 32 (20-40) points to post-operative 87 (40-100) points after the first follow-up and 90 (40-100) points after the second follow-up. Furthermore subjective shoulder function was evaluated using a visual analog scale. The average score improved from pre-operative 3 (0-6) points to post-operative 8 (4-10) points after the first and second follow-up. At the first follow-up 93% of the patients had a stable shoulder; 85% had a stable shoulder after arthroscopic stabilisation at the second follow-up. Arthroscopic treatment for posterior shoulder instability is a demanding procedure. Due to a special operative technique with specific instruments soft tissue pathologies found in this type of instability such as capsular redundancy and labral tears can be addressed. Our results show that it can be used as an effective tool for the treatment of posterior shoulder instability.
Hosseini
H
H
Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung, Marienstr. 72-90, 30171, Hannover, Deutschland. hhosseini@web.de
Agneskirchner
J D
JD
Lobenhoffer
P
P
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D012086:Reoperation; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*
J Bone Joint Surg Am. 1990 Aug;72(7):999-1002
2131791
Clin Sports Med. 1991 Oct;10(4):757-82
1934095
Clin Orthop Relat Res. 1993 Jun;(291):124-37
8504591
Am J Sports Med. 1998 Nov-Dec;26(6):753-8
9850774
J Bone Joint Surg Am. 1972 Jun;54(4):779-86
5055169
J Bone Joint Surg Am. 1980 Sep;62(6):897-908
7430177
Orthop Clin North Am. 1987 Jul;18(3):409-19
3327030
Instr Course Lect. 1989;38:211-5
2703716
J Bone Joint Surg Am. 1956 Oct;38-A(5):957-77
13367074
J Bone Joint Surg Am. 1989 Feb;71(2):205-16
2918005
Clin Orthop Relat Res. 1974;(103):150-6
4606782
Clin Orthop Relat Res. 1993 Jun;(291):54-66
8504614
Unfallchirurg. 1998 Oct;101(10 ):755-61
9847702
Acta Orthop Scand. 1986 Aug;57(4):324-7
3788495
J Bone Joint Surg Am. 1995 Jul;77(7):1011-20
7608222
J Bone Joint Surg Am. 1991 Jan;73(1):105-12
1985978
J Bone Joint Surg Am. 2003 Aug;85-A(8):1479-87
12925627
J Bone Joint Surg Am. 1992 Jul;74(6):890-6
1634579
Clin Orthop Relat Res. 1993 Jun;(291):85-96
8504618
Am J Sports Med. 1993 May-Jun;21(3):425-30; discussion 430-1
8346758
Am J Sports Med. 1994 Sep-Oct;22(5):578-84
7810778
J Bone Joint Surg Am. 2005 Apr;87(4):883-92
15805222
Am J Sports Med. 2005 Jul;33(7):996-1002
15890637
Arthroscopy. 1998 Mar;14(2):153-63
9531126
J Shoulder Elbow Surg. 1993 Jan;2(1):27-35
22959294
J Bone Joint Surg Br. 1984 Aug;66(4):551-6
6746691
Am J Sports Med. 1996 May-Jun;24(3):275-8
8734875
Am J Sports Med. 2006 Jul;34(7):1061-71
16567458
Arthroscopy. 1992;8(2):166-72
1637427
Am J Sports Med. 1981 May-Jun;9(3):135-9
7235108
Am J Sports Med. 1992 Jul-Aug;20(4):396-400
1415880