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Failed anterior reconstruction for shoulder instability.

R H Hawkins, R J Hawkins

    The Journal of Bone and Joint Surgery. British Volume
    |November 1, 1985
    PubMed
    Summary
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    Recurrent shoulder instability after anterior reconstruction often stems from unrecognized multidirectional instability or anatomical defects. Post-operative pain may also arise from impingement syndrome, even after successful stabilization.

    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Shoulder Reconstruction

    Background:

    • Anterior shoulder instability is a common condition requiring surgical reconstruction.
    • Persistent symptoms after surgery can significantly impact patient quality of life.

    Purpose of the Study:

    • To investigate the causes of persistent difficulties following anterior shoulder reconstruction for instability.
    • To identify factors contributing to recurrent instability and post-operative pain.

    Main Methods:

    • Retrospective study of 46 patients with ongoing issues after anterior shoulder reconstruction.
    • Analysis of patient records to identify reasons for persistent instability and pain.

    Main Results:

    • 31 patients experienced persistent instability, with 12 cases of unrecognized posterior/multidirectional instability and 11 with uncorrected anatomical defects.

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  • Significant pain in 20 patients was multifactorial, including impingement syndrome (9), osteoarthritis (7), and implant irritation (4).
  • 10 patients developed disabling medial rotation contractures, four with associated osteoarthritis.

    • Conclusions:

    • Recurrence of shoulder instability symptoms may indicate unrecognized instability direction or overly tight anterior repairs.
    • Post-stabilization pain is frequently linked to impingement syndrome, even when the primary instability is addressed.
    • Comprehensive diagnosis is crucial to address all contributing factors for successful shoulder reconstruction outcomes.