[Sports activity and proprioceptive ability after arthroscopic capsulolabral repair of post-traumatic shoulder instability].
OBJECTIVE
The aim of the study was to evaluate the clinical and functional outcome after arthroscopic transglenoid stabilisation of post-traumatic shoulder instabilities. Besides assessing the sports activity level, a special emphasis was put into evaluating the proprioceptive ability in a clinical-experimental setting as well as comparisons with a control group.


METHODS
We evaluated the functional results of 35 patients after arthroscopic stabilisation of post-traumatic, unidirectional anterior shoulder instabilities at a mean of 47.4 +/- 12.8 months postoperatively. Criteria such as subjective level of contentedness, range of motion, stability and sports activity as well as the Constant and Rowe scores were recorded. Joint position sense was assessed in 30 degrees internal and external rotation with the passive angle reproduction test using an inclinometer. The difference between the discerned and the target joint position was used as a measure of proprioceptive ability. Results were compared to the contralateral shoulder as well as to a control group consisting of 31 volunteers without any history of shoulder pain or injury. The Mann-Whitney U-test was used for statistical analysis.


RESULTS
The level of subjective satisfaction on a visual analogue scale was 9.3 +/- 1.1 points. ROM testing showed a mean loss of 4.8 +/- 5.1 degrees of external rotation compared to the contralateral shoulder. A mean Constant score of 88.9 +/- 7.8 and a mean Rowe score of 86.7 +/- 19.0 points were obtained. Four patients had a reluxation of the shoulder, in 3 cases due to an adequate traumatic event. 20 of 24 athletes (83 %) were able to return to their previous sports activity level without any restrictions. Passive angle reproduction testing showed no significant difference regarding the proprioceptive ability between operated shoulders in internal and external rotation (mean angle difference IRO = 2.6 +/- 1.4 degrees , ARO = 3.3 +/- 1.5 degrees ) compared to the contralateral shoulder (2.9 +/- 1.5 degrees , 3.6 +/- 1.8 degrees , p = 0.56/0.36) as well as compared to the control group (3.0 +/- 1.1 degrees , 3.4 +/- 1.1 degrees , p = 0.67/0.32).


CONCLUSIONS
The results of this study indicate that arthroscopic transglenoid shoulder stabilisation is a sufficient technique for the treatment of post-traumatic shoulder instability. Arthroscopic capsulolabral reconstruction led to a complete restoration of the proprioceptive ability in internal and external rotation. 83 % of the patients were able to return to their preoperative sports activity level.
Konrad
G G
GG
Department für Orthopädie und Traumatologie, Klinikum der Albert-Ludwigs-Universität Freiburg. Hugstetter Strasse 55, Freiburg. gerhard.konrad@uniklinik-freiburg.de
Rössler
V
V
Kreuz
P C
PC
Südkamp
N P
NP
D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D020127:Recovery of Function; D012783:Shoulder Dislocation / Q000601:surgery*