Retrospective study to survey the clinical and radiological results after arthroscopic revision surgery with renewed instability after open or arthroscopic shoulder stabilization

Status:

completed

Aims:

The successful operative stabilization of the shoulder is still a challenging task. Numerous mostly arthroscopic procedures applying suture anchors for the first stabilization have established. But the literature states various high reluxation rates up to 49%. In those difficult revision cases the open stabilization counted as gold standard so far.

Activities/Methods:

In the period from 2001 up to 2007 the examination of 21 patients after revised arthroscopic stabilization of the Glenohumeral joint with suture anchor took place. The average time period passed since surgery was 2,8 years (6 months up to 6.2 years). The average age at time of the surgery was 27.8 years (17-34 years). Before surgery all patient were examined by an MRT of the shoulder for diagnoses and medical indication. The patients had a clinical follow-up examination and there was a control MRT. Additionally DASH, ASES and modified Constant-Murley score were compiled. The MRT was evaluated by an independent radiologist.

Results:

A statistical significant difference between pre- and post-surgery stability occurred. A statistical significant correlation between the numbers of luxation, the time period between luxation and stabilization and the clinical outcome could not be prooved.
The MRT examination showed a good reconstruction of the labrum. The Constant-Murley score increased from 72 point pre-surgery to 90 points post-surgery, the ASES score raised from 59 to 88 points. The DASH score dropped from 42 to 9 points. There had been no more luxations with the follow-up examinees. Being interviewed, all patients would undergo the same surgery again.
The clinical outcome after arthroscopic revised stabilization within the examined cohort in respect to reluxation rates is at least equal to clinical results published for open revision surgery. In case an appropriate technique is applied the project managers see an alternative to the open procedure.

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