Postop observation vital for shoulder stabilization results

Following surgical shoulder stabilization, recurrent instability may be related more to patients' lifestyles rather than problems with the surgery itself, study results suggests.

Finding the true failure rate for shoulder stabilization may be dependent on having an independent follow-up observer, according to a Swedish study.

Jüri Kartus, MD, PhD, of Norra Älvsborg Hospital, Trollhättan, Sweden, and colleagues studied 81 patients with post-traumatic recurrent instability who had an extra-articular arthroscopic Bankart repair to evaluate their postoperative progress.

"The study has excellent methodology and should set examples of how to make follow-up studies," Kartus told Orthopedics Today.

Two investigators served as independent observers for patients operated on at the University Hospital of Salzburg in Austria. They examined 71 patients at 9 years median follow-up, finding that 27 patients had some form of instability, 14 of which were a single instability episode.

During clinical assessment, researchers found that, preinjury, 96% of patients had participated in sports, with 73% participating in overhead or contact sports. At final follow-up, 92% of patients still actively participated in sporting activities, of which 45% participated in overhead or contact sports.

Other findings included: 15% of patients had subluxations, 23% had redislocations and 10% had a previous revision surgery.

The researchers concluded that recurrent shoulder instability may not be caused by a faulty procedure, but instead may be influenced by a patient's lifestyle.

Because most of the recurrence of instability in the patients occurred 2 years postsurgery, the researchers encourage surgeons to have their patients participate in long-term follow-ups.

For more information:
Kartus J, Kartus C, Resch H, Matis N. A long-term follow-up study after arthroscopic extra-articular Bankart repair using absorbable tacks. #087. Presented at the American Academy of Orthopaedic Surgeons 73rd Annual Meeting. March 22-26, 2006. Chicago.
Jüri Kartus, MD, PhD, of Norra Älvsborg Hospital in Trollhättan, Sweden can be contacted at juri.kartus@vgregion.se. He reported that Smith and Nephew, Inc. provided institutional support to the University Hospital of Salzburg.