Postoperative functional outcome and stability in recurrent traumatic anteroinferior glenohumeral instability: comparison of two different surgical capsular reconstruction techniques

Arch Orthop Trauma Surg. 2004 May;124(4):226-31. doi: 10.1007/s00402-003-0601-1. Epub 2003 Dec 6.

Abstract

Introduction: Patients (n=62) with recurrent traumatic anterior or anteroinferior glenohumeral instability were prospectively evaluated with reference to the surgical reconstruction technique performed.

Materials and methods: Neer's T-plasty procedure was performed in group I (n=31) while a modified, anatomically orientated, anteroinferior capsular shift was performed in group II (n=31). All patients underwent an additional Bankart repair. After 18.1 (group II) and 22.2 (group I) months, patients were assessed in terms of subjective satisfaction, objective stability, range of motion, and functional outcome.

Results: No significant differences (91.5% group II, 87.8% group I) were noted between the study groups regarding the patient's subjective evaluation (p=0.17106). Results of Rowe's (93.1% group II, 87.9% group I; p=0.14419) and Constant's Score (96.5% group II, 93.8% group I; p=0.16582) showed no significant differences for both collectives. Postoperative lack of external rotation remained significantly smaller in group II (5.6 degrees +/-2.5 degrees ) compared with group I (9.8 degrees +/-2.5; p=0.00028). Although no significant differences (p=0.612) were found, the rate of recurrence was obviously smaller in group II (group II vs group I: 6 patients).

Conclusions: Our results demonstrate no significant differences between the two capsular reconstruction techniques regarding patient's satisfaction, Rowe and Constant Scores. However, the anatomically orientated anteroinferior capsular shift leads to a significantly smaller external rotation deficit and seems to offer a more reliable postoperative stability.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Joint Capsule / surgery*
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Recovery of Function / physiology
  • Recurrence
  • Shoulder Dislocation / etiology
  • Shoulder Injuries*
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Treatment Outcome