Hassanin Alkaduhimi1, N F J Hilgersom2, Denise Eygendaal3, M P J van den Bekerom4, Luke Oh2. 1. Massachusetts General Hospital, Orthopaedic Sports Department, Harvard Medical School, Boston, Massachusetts, U.S.A 2 Shoulder and elbow unit, Joint Research, OLVG Amsterdam, the Netherlands. 2. Massachusetts General Hospital, Orthopaedic Sports Department, Harvard Medical School, Boston, Massachusetts, U.S.A. 3. Orthopaedic Department, Amphia Ziekenhuis, Breda, the Netherlands 3 Orthopaedic Department, Academic Medical Center, Amsterdam, the Netherlands. 4. Shoulder and elbow unit, Joint Research, OLVG Amsterdam, the Netherlands.
Abstract
Background: This study aimed to assess the results after soft-tissue posterior instability surgery and address possible challenges during these operations. Methods: The databases of two tertiary hospitals were reviewed to identify patients treated for posterior shoulder instability between 2000 and 2015. Out of 198 treated patients, 19 cases underwent surgery with a mean follow-up of 35 months. Chart review was performed to obtain recurrence rates, revision rates, return to sport, persistent pain, subjective instability, subjective feeling of being better, complications, and range of motion after operative treatment of posterior shoulder instability. These outcomes were compared using the Fisher's exact and Mann-Whitney U tests. Results: After surgery, 6 (32%) patients had a recurrent subluxation, and 11 (58%) cases had persistent pain; moreover, 5 (26%) patients had a persistent feeling of instability, and 10 (53%) cases did not feel improvement after the operation. Furthermore, 10 (53%) patients required a revision, and there were 7 (37%) cases with a complication. Postoperatively, 75% of the patients had a full forward flexion, and 93% of the cases had full internal rotation; however, 64% of them had restrictions in external rotation. Conclusion: There is a high rate of recurrent instability, need for revision, and complications after soft-tissue posterior instability surgery. Postoperative external rotation was impaired in most patients. Patients should be informed about these unsatisfactory results.
Background: This study aimed to assess the results after soft-tissue posterior instability surgery and address possible challenges during these operations. Methods: The databases of two tertiary hospitals were reviewed to identify patients treated for posterior shoulder instability between 2000 and 2015. Out of 198 treated patients, 19 cases underwent surgery with a mean follow-up of 35 months. Chart review was performed to obtain recurrence rates, revision rates, return to sport, persistent pain, subjective instability, subjective feeling of being better, complications, and range of motion after operative treatment of posterior shoulder instability. These outcomes were compared using the Fisher's exact and Mann-Whitney U tests. Results: After surgery, 6 (32%) patients had a recurrent subluxation, and 11 (58%) cases had persistent pain; moreover, 5 (26%) patients had a persistent feeling of instability, and 10 (53%) cases did not feel improvement after the operation. Furthermore, 10 (53%) patients required a revision, and there were 7 (37%) cases with a complication. Postoperatively, 75% of the patients had a full forward flexion, and 93% of the cases had full internal rotation; however, 64% of them had restrictions in external rotation. Conclusion: There is a high rate of recurrent instability, need for revision, and complications after soft-tissue posterior instability surgery. Postoperative external rotation was impaired in most patients. Patients should be informed about these unsatisfactory results.
Entities:
Keywords:
Bankart; Dislocation; Glenohumeral; Instability; Posterior; Shoulder; Soft-tissue Surgery
Authors: J Garret; G Nourissat; M B Hardy; D Antonucci; P Clavert; P Mansat; A Godenèche Journal: Orthop Traumatol Surg Res Date: 2017-09-02 Impact factor: 2.256