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Posterior shoulder instability: prospective non-randomised comparison of operative and non-operative treatment in 51 patients

Cruz-Ferreira, Eduardo Miguel and Abadie, Pierre and Godenèche, Arnaud and Mansat, Pierre and Clavert, Philippe and Flurin, Pierre Henri Posterior shoulder instability: prospective non-randomised comparison of operative and non-operative treatment in 51 patients. (2017) Orthopaedics & Traumatology: Surgery & Research, 103 (8). S185-S188. ISSN 1877-0568

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Official URL: https://doi.org/10.1016/j.otsr.2017.08.004


BACKGROUND: The management of posterior shoulder instability remains controversial. Consequently, for a symposium on this topic, the French Arthroscopy Society (SFA) conducted a prospective multicentre study comparing outcomes of operative and non-operative treatment. OBJECTIVE: To compare outcomes after operative versus non-operative treatment of posterior shoulder instability. HYPOTHESIS: The surgical treatment of posterior shoulder instability may achieve better clinical outcomes than non-operative treatment in selected patients. MATERIAL AND METHODS: Fifty-one patients were included prospectively then followed-up for 12months. Three groups were defined based on the clinical presentation: recurrent dislocation or subluxation, involuntary instability or voluntary instability that had become involuntary, and shoulder pain with instability. Of the 51 patients, 19 received non-operative therapy involving a three-step rehabilitation programme and 32 underwent surgery with a posterior bone block, labral repair and/orcapsule tightening, or bone defect filling. At inclusion and at last follow-up, the Subjective Shoulder Value (SSV), Rowe score, Walch-Duplay score, and Constant score were determined. RESULTS: The preliminary results after the first 12 months are reported here. In the non-operative and operative groups, the Constant score was 78 versus 87, the Rowe score 64 versus 88, and the Walch-Duplay score 69 versus 82, respectively. These differences were statistically significant (P<0.05). DISCUSSION: To our knowledge, this study is the first comparison of non-operative versus operative treatment in a cohort of patients with documented posterior shoulder instability. Outcomes were better with operative treatment. However, this finding remains preliminary given the short follow-up of only 1 year.

Item Type:Article
HAL Id:hal-02135782
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Hôpitaux universitaires de Strasbourg - HUS (FRANCE)
Other partners > Centre Orthopédique Santy (FRANCE)
Other partners > Clinique du Sport de Bordeaux-Mérignac (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
Other partners > Unidade Local de Saúde de Guarda (PORTUGAL)
Other partners > Universidade da Beira Interior - UBI (PORTUGAL)
Deposited On:18 Mar 2019 11:45

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