Arthroscopic stabilization for atraumatic shoulder instability: minimum two-year outcomes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Atraumatic shoulder instability (type II glenohumeral instability) presents management challenges with limited surgical evidence.
• This study focuses on arthroscopic inferior capsular shift outcomes for type II instability.

Purpose of the Study:

• To evaluate the effectiveness and recurrence rates of arthroscopic inferior capsular shift for atraumatic type II shoulder instability.
• To identify predictors of recurrence following this surgical procedure.

Main Methods:

• Retrospective analysis of 72 shoulders in 70 patients undergoing arthroscopic inferior capsular shift (2013-2017).
• Inclusion criteria: atraumatic recurrent instability, minimum 2-year follow-up; exclusion: traumatic/structural instability.
• Analysis of pre- and post-operative outcomes, recurrence rates, and recurrence predictors.

Main Results:

• Significant improvements in pain scores, shoulder function (Stanmore PONS), and quality of life (Oxford Shoulder Score).
• A 39% recurrence rate of instability was observed, with 8.5% requiring revision surgery.
• Recurrence was more prevalent in females and patients under 30; hypermobility was not a predictor.

Conclusions:

• Arthroscopic inferior capsular shift offers functional and pain benefits for recalcitrant type II instability.
• High recurrence rates necessitate patient-specific surgical decisions and thorough pre-operative counseling, especially for younger females.
• Younger age and female gender are identified as significant predictors of recurrence.