The Outcomes of Soft-Tissue Repair for Posterior Instability Surgery

Document Type : RESEARCH PAPER

Authors

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. Level of evidence: IV

Keywords

References

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The Archives of Bone and Joint Surgery
Volume 10, Issue 1
January 2022
Pages 45-51

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History

  • Receive Date: 30 June 2019
  • Revise Date: 17 March 2021
  • Accept Date: 11 April 2021

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