Doo-Sup Kim1, Chang-Ho Yi, Ki-Yeon Kwon, Jin-Rok Oh. 1. Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Christian Hospital, 162 Ilsan-dong, Wonju-si, Gangwon-do, 220-701, Korea.
Abstract
PURPOSE: This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability. METHODS: Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups. RESULTS: The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels. CONCLUSION: The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
PURPOSE: This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability. METHODS: Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups. RESULTS: The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels. CONCLUSION: The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
Authors: John M Tokish; Colleen M McBratney; Daniel J Solomon; Lance Leclere; Christopher B Dewing; Matthew T Provencher Journal: J Bone Joint Surg Am Date: 2010-09 Impact factor: 5.284