title: A prospective cohort study investigating the effect of generalized joint hypermobility on outcomes after arthroscopic anterior shoulder stabilization.
abstract: OBJECTIVE
  Generalized joint laxity has been proposed as a significant risk factor for failure after arthroscopic anterior shoulder stabilization. The purpose of this study was to prospectively measure joint mobility in patients undergoing arthroscopic anterior shoulder stabilization and to determine whether hypermobility is a risk factor for worse outcomes compared with patients having normal joint mobility.
  
  
  METHODS
  Patients with anterior shoulder instability were prospectively enrolled. Generalized joint hypermobility was measured using the Beighton Hypermobility Score and the Rowe, UCLA, SANE, SST, and WOSI scores were administered and reported as patient outcomes preoperatively and following arthroscopic anterior shoulder stabilization at 6 weeks, 6 months, 12 months, and 24 months postoperatively. Patients were stratified into two groups based on their Beighton Hypermobility Score, with scores ≥ 4/9 indicative of joint hypermobility.
  
  
  RESULTS
  Sixteen patients with joint hypermobility (JH) and 18 non-hypermobile patients (NJH) were enrolled. At baseline, there were no significant differences in demographic characteristics or baseline patient-reported outcomes. Significantly more patients in the NJH group had SLAP tears (n = 10) compared to the JH group (n = 2) (p = .013). At all follow-up times, there were no significant differences between the NJH and JH groups with regard to patient-reported outcome scores (p > .05). In the JH group, 17% of patients reported recurrent instability at two years postoperatively compared to 25% of patients in the NJH group. There was no significant difference in failure rate (p = .67).
  
  
  CONCLUSIONS
  There was no significant difference in patient-reported outcomes or recurrent instability in patients with versus without joint hypermobility undergoing arthroscopic anterior shoulder stabilization.
authors.affiliation: a Department of Orthopedics , Kaiser Permanente Rock Creek , Lafayette , CO , USA.
authors.forename: Loukas
authors.initials: L
authors.lastname: Koyonos
authors.affiliation: b Department of Orthopedics , University of Colorado School of Medicine , Aurora , CO , USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kraeutler
authors.affiliation: c Department of Orthopaedic Surgery , University of Connecticut , Farmington , CT , USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: O'Brien
authors.affiliation: d The Rothman Institute , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ciccotti
authors.affiliation: d The Rothman Institute , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dodson
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications*; D008297:Male; D019637:Orthopedic Procedures; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D012782:Shoulder / Q000601:surgery*; D012783:Shoulder Dislocation / Q000601:surgery*; D000070599:Shoulder Injuries / Q000209:etiology; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Beighton hypermobility score; Generalized joint hypermobility; anterior shoulder stabilization; shoulder instability