Related Experiment Video
Updated: May 3, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Arthroscopic Stabilization of Shoulder Instability in Children and Adolescents With Open Physes: Minimum Two-year
Halle R Walls1,2,3, Paul J Chung1,2, Rajvarun S Grewal1
1Department of Orthopedics, Rady Children's Hospital, San Diego.
Background:
Outcomes following shoulder instability events suggest high rates of recurrence for the pediatric population. Previous studies have not focused on those with open physes at the proximal humerus, and longer-term surgical outcomes have not been evaluated for this population. The purpose of the current study is to evaluate patient-reported outcomes and recurrence rates in skeletally immature children and adolescents undergoing arthroscopic stabilization procedures.
Methods:
A retrospective review of all skeletally immature patients who underwent arthroscopic shoulder stabilization between 2009 and 2021 from 2 pediatric hospitals was performed. Demographic, injury, imaging, and intraoperative data were recorded. Patient-reported outcomes, including the Pediatric/Adolescent Shoulder Survey (PASS), return to sport, instability recurrence, and need for revision surgery, were documented. Statistical analysis was performed to assess risk factors for recurrence.
Results:
One hundred one skeletally immature patients met the inclusion criteria. The mean age at the time of surgery was 14.8 ± 1.4 years, and 74% were males. The majority of patients had anterior instability (78%), 17% had posterior instability, and 5% had multidirectional instability. Contact sports were responsible for 47% of injuries. The average number of dislocations before surgery was 2.6 ± 3.4. At a mean follow-up of 5.1 ± 2.9 years, the mean PASS score was 88 ± 14. A total of 35 patients (34.7%) experienced recurrent instability, and 10 patients (10%) had a revision procedure. Patients with recurrent instability were found to be younger, had longer clinical follow-up duration, and had a lower final PASS score. Direction of instability was not associated with recurrence rate. Other factors such as sex, number of dislocations before surgical intervention, and participation in contact sports were not significantly associated with recurrent instability.
Conclusions:
While the majority of skeletally immature children and adolescents undergoing arthroscopic shoulder stabilization can achieve favorable outcomes, recurrent instability remains a problem, as ∼1 in 3 patients may experience recurrent instability with younger patients being at particular risk.
Level Of Evidence:
Level IV-retrospective case series prognostic study.
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