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Arthroscopic Stabilization for Voluntary Shoulder Instability

Greiwe, Raymond Michael MD*; Galano, Greg MD; Grantham, Jeff BS; Ahmad, Christopher S. MD

Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e31826b6ee1
Trauma-Upper Extremity
Abstract

Background: Voluntary shoulder instability is characterized by a patient’s ability to sublux their shoulder using selective muscle contraction and relaxation. High failure rates exist with open shoulder stabilization in this group of patients. The purpose of this study was to report the outcomes for patients with voluntary instability treated arthroscopically.

Methods: All patients with voluntary instability from 2006 to 2008 treated with arthroscopic stabilization were included. All patients had documentation of preoperative and postoperative American Shoulder and Elbow Surgeons (ASES) questionnaire score, visual analogue scale of pain, simple shoulder test, and range of motion. Subjective satisfaction and return to sport was also determined.

Results: Ten patients were identified for inclusion in the study. The average age of the 5 male and 5 female patients was 16.2±2.33 years. Average clinical follow-up period was 31±6.5 months. Visual analogue scale scores improved from 5.33±3.50 preoperatively to 1.44±2.0 postoperatively, ASES scores improved from 52.2±18.7 to 85.9±14.9 and simple shoulder test improved from 8.17±3.19 to 11.4±1.01. All of the functional evaluation scores improved postoperatively (P<0.05). There was no case of postoperative dislocation or subluxation, all reported excellent subjective outcome, and all those who played sports returned to their previous level.

Conclusions: Good and excellent outcomes can be obtained with arthroscopic stabilization for patients with voluntary instability. Improved results from previous reports may be related to improved patient selection, surgical technique, and postoperative rehabilitation. Although long-term follow-up and comparative studies are necessary, arthroscopic stabilization seems to be an acceptable treatment option for patients who fail nonoperative treatment.

Level of Evidence: Level IV, case series, retrospective review.

Author Information

*St Elizabeth’s Hospital Medical Center and Commonwealth Orthopaedics, Edgewood, KY

Hospital for Special Surgery

Department of Orthopaedic Surgery, Orthopaedic Surgery Center for Shoulder, Elbow, and Sports Medicine, Columbia University, Columbia-Presbyterian Hospital, New York, NY

Financial Disclosure: None.

IRB: Columbia University IRB # AAAC5442.

Dr Ahmad is a consultant for Arthrex. The other authors have no conflict of interest.

Reprints: Christopher S. Ahmad, MD, 622 W 168th Street, PH-11-Center, New York, NY 10032. E-mail: csa4@columbia.edu.

© 2012 Lippincott Williams & Wilkins, Inc.