title: The role of arthroscopic capsulo-labral repair in unidirectional post-traumatic shoulder instability in adolescent athletes participating in overhead or contact sports.
abstract: OBJECTIVE
  this study was performed to identify the role of arthroscopic capsulo-labral repair (ACR) in unidirectional post-traumatic shoulder instability in adolescent athletes participating in overhead or contact sports.
  
  
  METHODS
  sixty-five adolescent patients (aged 13 to 18 years) with post-traumatic shoulder instability submitted to arthroscopic surgery were selected from our database. The mean follow-up duration was 63 months. Shoulder range of motion and functional outcomes were evaluated preoperatively and postoperatively using the Single Assessment Numeric Evaluation (SANE), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores. In addition, details in the database on the type of sport practiced, time until surgery, and number of dislocations were analyzed to look for possible correlations with the recurrence rate.
  
  
  RESULTS
  at the final follow-up, the mean SANE score was 87.23% (range: 30% to 100%) (preoperative mean score: 46.15% [range, 20% to 50%]); the mean Rowe score was 85 (range: 30 to 100) (preoperative mean score: 35.9 [range: 30 to 50]); and the mean ASES score was 84.12 (range: 30 to 100) (preoperative mean score: 36.92 [range: 30 to 48]). Mean forward flexion and external rotation with the arm at 90° abduction did not show changes compared with preoperative values; 81.5% of the patients returned to their pre-injury level of sports activities, and the failure rate was 21.5%. The recurrence rate was not related to the postoperative scores (p = 0.556 for SANE, p = 0.753 for Rowe, and p = 0.478 for ASES), number of preoperative episodes of instability (p = 0.59), or time that elapsed between the first instability episode and the surgery (p = 0.43). A statistically significant association (p = 0.0021) was found between recurrence and the type of sport practiced.
  
  
  CONCLUSIONS
  ACR is a reasonable surgical option in an adolescent population participating in sports. It has a role in restoring shoulder stability with very low morbidity; however, the failure rate is higher than in the adult population and both the young patients and their relatives must be properly informed about the expected outcome of the procedure.
  
  
  METHODS
  level IV, therapeutic case series.
authors.affiliation: Shoulder Department, IRCCS Humanitas Institute, Rozzano, Milan, Italy.
authors.forename: Giacomo Delle
authors.initials: GD
authors.lastname: Rose
authors.affiliation: Shoulder Department, IRCCS Humanitas Institute, Rozzano, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Borroni
authors.affiliation: Shoulder Department, IRCCS Humanitas Institute, Rozzano, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Castagna
keywords: adolescents; arthroscopy; athletes; instability; shoulder