title: Arthroscopic stabilization for voluntary shoulder instability.
abstract: BACKGROUND
  Voluntary shoulder instability is characterized by a patient's ability to sublux their shoulder using selective muscle contraction and relaxation. High failure rates exist with open shoulder stabilization in this group of patients. The purpose of this study was to report the outcomes for patients with voluntary instability treated arthroscopically.
  
  
  METHODS
  All patients with voluntary instability from 2006 to 2008 treated with arthroscopic stabilization were included. All patients had documentation of preoperative and postoperative American Shoulder and Elbow Surgeons (ASES) questionnaire score, visual analogue scale of pain, simple shoulder test, and range of motion. Subjective satisfaction and return to sport was also determined.
  
  
  RESULTS
  Ten patients were identified for inclusion in the study. The average age of the 5 male and 5 female patients was 16.2 ± 2.33 years. Average clinical follow-up period was 31 ± 6.5 months. Visual analogue scale scores improved from 5.33 ± 3.50 preoperatively to 1.44 ± 2.0 postoperatively, ASES scores improved from 52.2 ± 18.7 to 85.9 ± 14.9 and simple shoulder test improved from 8.17 ± 3.19 to 11.4 ± 1.01. All of the functional evaluation scores improved postoperatively (P < 0.05). There was no case of postoperative dislocation or subluxation, all reported excellent subjective outcome, and all those who played sports returned to their previous level.
  
  
  CONCLUSIONS
  Good and excellent outcomes can be obtained with arthroscopic stabilization for patients with voluntary instability. Improved results from previous reports may be related to improved patient selection, surgical technique, and postoperative rehabilitation. Although long-term follow-up and comparative studies are necessary, arthroscopic stabilization seems to be an acceptable treatment option for patients who fail nonoperative treatment.
  
  
  METHODS
  Level IV, case series, retrospective review.
authors.affiliation: St Elizabeth's Hospital Medical Center and Commonwealth Orthopaedics, Edgewood, KY, USA.
authors.forename: Raymond Michael
authors.initials: RM
authors.lastname: Greiwe
authors.forename: Greg
authors.initials: G
authors.lastname: Galano
authors.forename: Jeff
authors.initials: J
authors.lastname: Grantham
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D018579:Patient Selection; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome