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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Retrospective analysis of decision-making in post-traumatic posterior shoulder instability
Simon Bovenkerk1, Carsten Englert2,3
1Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
International Orthopaedics
|December 4, 2023
Summary
Post-traumatic posterior shoulder instability (PSI) can be effectively managed conservatively for patients with mild symptoms. Surgery is recommended for persistent cases, with arthroscopic procedures yielding high success rates.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Traumatology
Background:
- Post-traumatic posterior shoulder instability (PSI) significantly impacts patient quality of life.
- Effective decision-making for operative versus conservative management of PSI is crucial.
Purpose of the Study:
- To assess clinical outcomes for post-traumatic PSI management.
- To refine decision-making criteria for operative and conservative treatments in PSI.
Main Methods:
- Retrospective analysis of 28 patients with post-traumatic PSI over five years.
- Exclusion of degenerative or genetic causes of PSI.
- Evaluation of conservative treatment failure based on active shoulder stabilization and imaging findings (bony/cartilage defects).
- Treatment success assessed using the Western Ontario Shoulder Instability (WOSI) Score, Range of Motion (ROM), and X-ray.
Main Results:
- Overall, 25 out of 28 patients achieved good to excellent results.
- 11 patients received conservative treatment, 7 underwent immediate surgery, and 10 transitioned from conservative to operative care.
- Patients managed conservatively with persistent symptoms had significantly lower initial WOSI scores compared to the operative group.
Conclusions:
- Conservative management is viable for post-traumatic PSI with low initial symptom burden (low WOSI score) and no absolute surgical indications.
- Arthroscopic surgery is an effective option for indicated cases, achieving good to excellent outcomes in 16 of 17 patients.
