Arthroscopic Capsulolabral Reconstruction for Posterior Shoulder Instability in Patients 18 Years Old or Younger

The purpose of this study was to determine clinical outcomes for pain, function, instability, and return to activity level and sport in patients 18 years old or younger, treated with arthroscopic capsulolabral reconstruction for posterior instability of the shoulder.

We retrospectively reviewed 22 athletes (25 shoulders) with unidirectional recurrent posterior shoulder instability treated with arthroscopic posterior capsulolabral reconstruction from 2002 to 2009. The study group included 19 males and 3 females with a mean age of 17 years. Patients were evaluated at a mean of 63 months postoperatively with American Shoulder and Elbow Surgeons (ASES) composite scores and subset scores for pain, stability, and function, as well as Marx activity scores. Statistical analysis was performed for continuous and categorical variables with significance set at α=0.05.

The overall mean postoperative ASES and Marx scores were 74.3 (SD±20) and 14.8 (SD±3.2), respectively. Twenty-three shoulders were stable at the time of final follow-up (92%). Two shoulders had traumatic recurrent episodes of posterior instability. Return to sport at the same level was achieved in 67% of athletes. Overall postoperative ASES scores were significantly higher in male patients (P=0.04), those with traumatic injuries (P=0.03), and in contact athletes (P<0.01). Postoperative Marx scores were significantly higher in male patients (P<0.01). Preoperative and postoperative range of motion were assessed and without significant difference.

Arthroscopic capsulolabral reconstruction is an effective treatment for symptomatic unidirectional posterior glenohumeral instability in 18 years old or younger. In distinction to treatment of anterior instability, outcomes in this series were improved in males, contact athletes, and patients with a traumatic etiology of posterior glenohumeral instability.

Level IV.