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Arthroscopic repair for traumatic posterior shoulder instability
Riley J Williams1, Sabrina Strickland, Matthew Cohen
1Sports Medicine and Shoulder Service, Hospital for Special Surgery, Cornell University Medical College, New York, New York, USA.
Background:
The role of arthroscopic repair in the treatment of posterior shoulder instability remains poorly defined.
Purpose:
To evaluate the results of arthroscopic repair of posterior Bankart lesions.
Study Design:
Retrospective review.
Methods:
Records were reviewed of 27 shoulders (26 patients). All of the patients were male with a mean age of 28.7 years; in all cases symptoms were preceded by a traumatic event. Fourteen of the patients had 2+ to 3+ posterior translation noted under preoperative anesthesia. The posterior capsulolabral complex was found to be detached from the glenoid rim in all cases; bioabsorbable tack fixation was used for repair.
Results:
At a mean follow-up of 5.1 years, no patients demonstrated a range of motion deficit. Muscle weakness (grade 4/5) in external rotation was noted in two patients (8%). There was no instability greater than 1+ in the anterior, posterior, or inferior directions. The mean L'Insalata shoulder score was 90.0 +/- 13.9. The mean SF-36 physical and mental component scores were 50.4 +/- 7 and 53.9 +/- 9, respectively. Symptoms of pain and instability were eliminated in 24 patients (92%). Two patients (8%) required additional surgery after arthroscopic repair of the posterior Bankart lesion. Radiographs demonstrated that there had been no progressive glenohumeral joint degeneration.
Conclusions:
Arthroscopic repair of the posterior capsulolabral complex is an effective means of eliminating symptoms of pain and instability associated with posterior Bankart lesions of traumatic origin.
