J Garret1, G Nourissat2, M B Hardy3, D Antonucci4, P Clavert5, P Mansat6, A Godenèche7. 1. Clinique du Parc, 155, boulevard Stalingrad, 69006 Lyon, France. Electronic address: j.garret@cliniqueduparclyon.com. 2. Clinique des Maussins-Ramsay-Générale-de-Santé, 67, rue de Romainville, 75019 Paris, France. Electronic address: gnourissat@wanadoo.fr. 3. Clinique Mutualiste Chirurgicale, 3, rue le Verrier, 42100 Saint-Étienne, France. Electronic address: mariebeatricehardy@gmail.com. 4. Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: antonucci.diego01@gmail.com. 5. Service de chirurgie du membre supérieur, CCOM, Laboratoire iCube, CNRS UMR 7357, Équipe 12 Matériaux Multi-échelles et Biomécanique, Institut de Mécanique des Fluides et des Solides, CHRU de Strasbourg, 2-4, rue Boussingault, 67000 Strasbourg, France. Electronic address: philippe.clavert@chru-strasbourg.fr. 6. Département d'Orthopédie-Traumatologie, Hôpital Riquet, CHU-Purpan, place du Dr.-Baylac, 31059 Toulouse, France. Electronic address: mansat.p@chu-toulouse.fr. 7. Ransay Générale de Santé, Centre Orthopédique Santy, Hôpital Privé Jean-Mermoz, 69008 Lyon, France. Electronic address: arnaud.godeneche@wanadoo.fr.
Abstract
BACKGROUND: Painful posterior shoulder instability (PPSI) is the least common of the three clinical patterns of posterior shoulder instability. PPSI is defined as pain combined with anatomical evidence of posterior instability but no instability events. MATERIAL AND METHOD: We studied a multicentre cohort of 25 patients with PPSI; 23 were identified retrospectively and had a follow-up of at least 2 years and 2 patients were included prospectively. Most patients engaged in sports. RESULTS: All 25 patients underwent surgery, which usually consisted in arthroscopic capsulo-labral reconstruction. The outcome was excellent in 43% of patients; another 43% had improvements but reported persistent pain. The pain remained unchanged or worsened in the remaining 14% of patients. Causes of failure consisted of a missed diagnosis of shoulder osteoarthritis with posterior subluxation, technical errors, and postoperative complications. The main cause of incomplete improvement with persistent pain was presence of cartilage damage. CONCLUSION: Outcomes were excellent in patients who were free of cartilage damage, bony abnormalities associated with posterior instability (reverse Hill-Sachs lesion, erosion or fracture of the posterior glenoid), technical errors, and postoperative complications.
BACKGROUND: Painful posterior shoulder instability (PPSI) is the least common of the three clinical patterns of posterior shoulder instability. PPSI is defined as pain combined with anatomical evidence of posterior instability but no instability events. MATERIAL AND METHOD: We studied a multicentre cohort of 25 patients with PPSI; 23 were identified retrospectively and had a follow-up of at least 2 years and 2 patients were included prospectively. Most patients engaged in sports. RESULTS: All 25 patients underwent surgery, which usually consisted in arthroscopic capsulo-labral reconstruction. The outcome was excellent in 43% of patients; another 43% had improvements but reported persistent pain. The pain remained unchanged or worsened in the remaining 14% of patients. Causes of failure consisted of a missed diagnosis of shoulder osteoarthritis with posterior subluxation, technical errors, and postoperative complications. The main cause of incomplete improvement with persistent pain was presence of cartilage damage. CONCLUSION: Outcomes were excellent in patients who were free of cartilage damage, bony abnormalities associated with posterior instability (reverse Hill-Sachs lesion, erosion or fracture of the posterior glenoid), technical errors, and postoperative complications.
Authors: Matthew L Vopat; Reed G Coda; Nick E Giusti; Jordan Baker; Armin Tarakemeh; John P Schroeppel; Scott Mullen; Jeffrey Randall; Matthew T Provencher; Bryan G Vopat Journal: Orthop J Sports Med Date: 2021-05-25
Authors: Jordan W Fried; Eoghan T Hurley; Matthew L Duenes; Amit K Manjunath; Mandeep Virk; Guillem Gonzalez-Lomas; Kirk A Campbell Journal: Arthrosc Sports Med Rehabil Date: 2020-12-24