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Arthroscopic treatment of multidirectional glenohumeral instability in young overhead athletes.

Voigt C, Schulz AP, Lill H - Open Orthop J (2009)

Bottom Line: At the final follow-up all patients were satisfied; Rowe Score showed 7 "excellent" and "good" results; Constant Score was "excellent" and "good" in 6, and "fair" in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.The described arthroscopic technique stabilizes glenohumeral joint.A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Reconstructive Surgery, Friederikenstift Hospital Hannover, Humboldtstrasse 5, D-30169 Hannover, Germany.

ABSTRACT

Purpose: This prospective case series evaluates the outcome, and the return to sports of young overhead athletes with a persistent, symptomatic multidirectional instability (MDI) with hyperlaxity type Gerber B5 treated with an arthroscopic anteroposteroinferior capsular plication and rotator interval closure.

Methods: 9 young overhead athletes (10 shoulders) with the rare diagnosis of MDI (Gerber B5) and an indication for operative treatment, after a failed physiotherapy program were physically examined 3, 6 and 12 months postoperatively by a physical examination, and got a final phone interview after median 39 months.

Results: At the final follow-up all patients were satisfied; Rowe Score showed 7 "excellent" and "good" results; Constant Score was "excellent" and "good" in 6, and "fair" in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.

Conclusion: Symptomatic MDI requires an individual indication for surgical treatment after a primary conservative treatment. The described arthroscopic technique stabilizes glenohumeral joint. A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.

No MeSH data available.


Posteroinferior capsular shift (16 years, female). Left shoulder, lateral position; view from anterosuperior. H: Humerus, G: Glenoid, pC: posterior Capsule, pCP: posterior Capsular Plication.
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Figure 2: Posteroinferior capsular shift (16 years, female). Left shoulder, lateral position; view from anterosuperior. H: Humerus, G: Glenoid, pC: posterior Capsule, pCP: posterior Capsular Plication.

Mentions: In case of a well-developed labrum capsular plication was realized by sutures, which were passed through labrum and capsular tissue. If labrum was atrophic, suture anchors (Suture tak, Fa Arthrex, Naples, USA) were inserted to the glenoid rim to perform capsular shift. By a shuttle relay (90° curved lasso), or alternatively an angled instrument with a sharp tip capsule tissue was grasped, and perforated about 1 to 1.5 cm lateral to the glenoid rim, nonabsorbable sutures (Fiber wire 2, Fa Arthrex, Naples, USA) were passed through the tissue in an O-shaped fashion, and posteroinferior capsular plication was performed (Fig. 2).


Arthroscopic treatment of multidirectional glenohumeral instability in young overhead athletes.

Voigt C, Schulz AP, Lill H - Open Orthop J (2009)

Posteroinferior capsular shift (16 years, female). Left shoulder, lateral position; view from anterosuperior. H: Humerus, G: Glenoid, pC: posterior Capsule, pCP: posterior Capsular Plication.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2813070&req=5

Figure 2: Posteroinferior capsular shift (16 years, female). Left shoulder, lateral position; view from anterosuperior. H: Humerus, G: Glenoid, pC: posterior Capsule, pCP: posterior Capsular Plication.
Mentions: In case of a well-developed labrum capsular plication was realized by sutures, which were passed through labrum and capsular tissue. If labrum was atrophic, suture anchors (Suture tak, Fa Arthrex, Naples, USA) were inserted to the glenoid rim to perform capsular shift. By a shuttle relay (90° curved lasso), or alternatively an angled instrument with a sharp tip capsule tissue was grasped, and perforated about 1 to 1.5 cm lateral to the glenoid rim, nonabsorbable sutures (Fiber wire 2, Fa Arthrex, Naples, USA) were passed through the tissue in an O-shaped fashion, and posteroinferior capsular plication was performed (Fig. 2).

Bottom Line: At the final follow-up all patients were satisfied; Rowe Score showed 7 "excellent" and "good" results; Constant Score was "excellent" and "good" in 6, and "fair" in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.The described arthroscopic technique stabilizes glenohumeral joint.A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Reconstructive Surgery, Friederikenstift Hospital Hannover, Humboldtstrasse 5, D-30169 Hannover, Germany.

ABSTRACT

Purpose: This prospective case series evaluates the outcome, and the return to sports of young overhead athletes with a persistent, symptomatic multidirectional instability (MDI) with hyperlaxity type Gerber B5 treated with an arthroscopic anteroposteroinferior capsular plication and rotator interval closure.

Methods: 9 young overhead athletes (10 shoulders) with the rare diagnosis of MDI (Gerber B5) and an indication for operative treatment, after a failed physiotherapy program were physically examined 3, 6 and 12 months postoperatively by a physical examination, and got a final phone interview after median 39 months.

Results: At the final follow-up all patients were satisfied; Rowe Score showed 7 "excellent" and "good" results; Constant Score was "excellent" and "good" in 6, and "fair" in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.

Conclusion: Symptomatic MDI requires an individual indication for surgical treatment after a primary conservative treatment. The described arthroscopic technique stabilizes glenohumeral joint. A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.

No MeSH data available.