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Promising results found with arthroscopic surgery for multidirectional shoulder instability

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ORLANDO, Fla. — Results of early outcomes presented here support the use of arthroscopic treatment for patients with multidirectional glenohumeral instability.

“Overall, patient satisfaction postoperative was nine out of 10,” Martin Brett Raynor, MD, said during his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “The subgroup analysis looking at traumatic onset vs. atraumatic onset, the atraumatic group had overall lower postoperative scores than the traumatic group, but they still had significant improvement from preoperatively. The only exception was the SANE score.”

Researchers included 41 patients (45 shoulders) with multidirectional instability (MDI) of the shoulder who underwent an arthroscopic pancapsular shift and had been out from surgery for at least 2 years. Average follow-up was 2.9 years. Researchers retrospectively reviewed prospectively collected data including patient satisfaction, instability symptoms, American Shoulder and Elbow Society shoulder index, Quick-DASH, Single Assessment Numeric Evaluation (SANE) and SF-12 scores.

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Of 39 patients, 32 observed preoperative instability events during a recreational or competitive sport. At a mean of 25 months, four of the 45 patients underwent a second instability surgery. According to Raynor, Kaplan-Meier survivorship was 100% at 1 year and 87% at 3 years.

“Overall there was significant improvement in all outcomes scores with the exception of the mental component of SF-12,” Raynor said. “We also had some subjective stability scores and patient outcome scores, which also improved.

Raynor said 73% returned to play at the same or below preinjury levels.

“Interestingly, there was 83% return to play for those who had traumatic onset of their MDI compared to only 50% for those with atraumatic onset of their MDI,” Raynor said. – by Monica Jaramillo

Reference:

Raynor MB, et al. Paper #25. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-12, 2015; Orlando, Fla.

Disclosure: Raynor reports he has stock in Merck.