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Outcomes of capsulolabral reconstruction for posterior shoulder instability

Andrieu, Kevin and Barth, Johannes and Saffarini, Mo and Clavert, Philippe and Godenèche, Arnaud and Mansat, Pierre Outcomes of capsulolabral reconstruction for posterior shoulder instability. (2017) Orthopaedics & Traumatology: Surgery & Research, 103 (8). S189-S192. ISSN 1877-0568

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Official URL: https://doi.org/10.1016/j.otsr.2017.08.002

Abstract

BACKGROUND: Surgical treatment of isolated posterior shoulder instability-a rare and often misdiagnosed condition-is controversial because of poor outcomes. Failure of physical therapy in symptomatic young athletes requires capsulolabral reconstruction or bone block procedures. The goal of this study was to report the outcomes of patients who have undergone surgical capsulolabral reconstruction and to look for risk factors that contribute to failure of this procedure. MATERIAL AND METHOD: We analyzed the outcomes of 101 patients who underwent capsulolabral reconstruction: 83 included retrospectively, 18 included prospectively. The procedures were performed alone or in combination with capsular shift, labral repair, closure of the rotator interval and notch remplissage. The primary endpoint was failure of the procedure, defined as recurrence of the instability and/or pain. We also determined the outcomes based on specific (Walch-Duplay, modified Rowe) and non-specific (Constant, resumption of activities) scores of shoulder instability. RESULTS: The results were satisfactory despite a high failure rate: 35% in the retrospective cohort with 4.8±2.6 years' follow-up and 22% in the prospective cohort with 1.1±0.3 years' follow-up. The various outcome scores improved significantly. Ninety-two percent of patients returned to work and 80% of athletes returned to their pre-injury level of sports. Eighty-five percent of patients were satisfied or very satisfied after the surgery. No risk factors for failure were identified; however, failures were more common in older patients, those who underwent an isolated procedure and those who had unclassified clinical forms. CONCLUSION: Treatment of posterior shoulder instability by capsulolabral reconstruction leads to good clinical outcomes; however, the recurrence rate is high.

Item Type:Article
HAL Id:hal-02135076
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Centre Hospitalier Universitaire de Nantes - CHU Nantes (FRANCE)
Other partners > Hôpitaux universitaires de Strasbourg - HUS (FRANCE)
Other partners > Centre Orthopédique Santy (FRANCE)
Other partners > Clinique des Cèdres - Échirolles (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
Laboratory name:
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Deposited By: Pascal SWIDER
Deposited On:11 Apr 2019 07:56

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