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Updated: Aug 9, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Posterior shoulder instability: Prospective non-randomised comparison of operative and non-operative treatment in 51
E Cruz-Ferreira1, P Abadie2, A Godenèche3
1Orthopaedic Surgery Fellow, Clinique du Sport Bordeaux, 4, rue Négrevergne, 33700 Mérignac, France; Orthopaedic Surgery, Sousa Martins Hospital, City of Guarda, Portugal; Faculdade de Ciências da Saúde, Universidade da Beira Interior, City of Covilhã, Portugal.
Background:
The management of posterior shoulder instability remains controversial. Consequently, for a symposium on this topic, the French Arthroscopy Society (SFA) conducted a prospective multicentre study comparing outcomes of operative and non-operative treatment.
Objective:
To compare outcomes after operative versus non-operative treatment of posterior shoulder instability.
Hypothesis:
The surgical treatment of posterior shoulder instability may achieve better clinical outcomes than non-operative treatment in selected patients.
Material And Methods:
Fifty-one patients were included prospectively then followed-up for 12months. Three groups were defined based on the clinical presentation: recurrent dislocation or subluxation, involuntary instability or voluntary instability that had become involuntary, and shoulder pain with instability. Of the 51 patients, 19 received non-operative therapy involving a three-step rehabilitation programme and 32 underwent surgery with a posterior bone block, labral repair and/orcapsule tightening, or bone defect filling. At inclusion and at last follow-up, the Subjective Shoulder Value (SSV), Rowe score, Walch-Duplay score, and Constant score were determined.
Results:
The preliminary results after the first 12 months are reported here. In the non-operative and operative groups, the Constant score was 78 versus 87, the Rowe score 64 versus 88, and the Walch-Duplay score 69 versus 82, respectively. These differences were statistically significant (P<0.05).
Discussion:
To our knowledge, this study is the first comparison of non-operative versus operative treatment in a cohort of patients with documented posterior shoulder instability. Outcomes were better with operative treatment. However, this finding remains preliminary given the short follow-up of only 1 year.
Level Of Evidence:
III, case-control study.
