Functional outcome after arthroscopic repair of triple shoulder instability☆

This was an analytical retrospective study of patients who underwent arthroscopic treatment of triple labral lesion from March 2005 to December 2014. Patients with at least one year of postoperative follow-up were included. A total of nine patients were evaluated. The mean age was 32.3 years and the dominant side was affected in five patients. Patients were functionally assessed regarding the range of motion (ROM) in elevation, external rotation with the arm close to the body the arm in abduction of 90°, and internal rotation, and by the Carter-Rowe score. The degree of satisfaction was assessed at the end of the follow-up period.

RESULTS:

Three patients had less than five episodes of instability, four patients had between five and ten episodes, and two patients had more than ten episodes. Seven patients had positive O'Brien test for SLAP lesions and positive apprehension test in abduction and external rotation, and only one patient had apprehension in adduction and internal rotation. Three patients persisted with positive O'Brien test and one with apprehension in abduction and external rotation at the end of follow-up. The range of motion was complete in all cases. The median Carter-Rowe score increased from 40 preoperatively to 90 (p = 0.008).

CONCLUSION:

The arthroscopic repair of triple labral lesions allows for the restoration of the stability of the glenohumeral joint, achieving excellent functional results.

Keywords:
Arthroscopy/methods; Shoulder; Rotator cuff; Patient satisfaction; Articular motion range

Stability	Note
No recurrences, subluxations, or apprehension	50
Apprehension when the arm was placed in certain positions	30
Subluxations (with no need for reductions)	10
Recurrent dislocation	0
Movement
100% of the movement	20
75% of normal movement	15
50% of the normal ER, 75% of the normal AE and IR	5
50% of the normal AE, IR, and ER	0

Function
Without limitation to sport or work activities. Minimal or no discomfort	30
Small limitation and minimal discomfort	25
Moderate limitation and discomfort	10
Severe limitation and pain	0
Total possible points	100

	Carter pre				Carter post
	Stability	ROM	Function	Total	Stability	ROM	Function	Total	p-Value
DLAN	0	20	25	45	50	15	25	90	<0.05
GCV	0	20	10	30	30	20	25	75	<0.05
BL	0	15	25	40	50	15	30	95	<0.05
ECR	30	15	10	55	50	20	10	80	<0.05
FFS	0	15	10	25	30	20	10	60	<0.05
GNS	0	15	10	25	50	15	25	95	<0.05
YAC	30	20	10	60	50	15	25	90	<0.05
CFGS	30	20	10	60	50	20	30	100	<0.05
CJF	10	20	10	40	50	20	30	100	<0.05
MEAN				42.2				87.2	<0.05

	DLAN	GCV	BL	ECR	FFS	GNS	YAC	CFGS	CJF	Mean	p-Value
AE
Pre-op	180	180	180	180	180	180	150	180	180	177	0.317
Post-op	180	180	180	180	180	180	180	180	180	180

ER2
Pre-op	90	90	90	90	100	90	60	90	120	91.1	0.357
Post-op	80	45	90	90	100	90	80	90	100	85

ER1
Pre-op	60	80	45	80	80	80	45	80	100	72.2	0.715
Post-op	60	50	80	80	80	80	70	80	90	74.4

IR
Pre-op	T9	T7	T8	T7	T7	T7	T12	T7	T7	T 7.8	<0.05
Post-op	T9	T7	T8	T8	T7	T7	T7	T7	T7	T 7.4

	DLAN	GCV	BL	ECR	FFS	GNS	YAC	CFGS	CJF
O’Brien test
Pre-op	Neg	+	+	+	+	Neg	+	+	+
Post-op	Neg	+	Neg	+	Neg	Neg	+	Neg	Neg

Apprehension in abduction and ER
Pre-op	+	Neg	+	+	+	Neg	+	+	+
Post-op	Neg	+	Neg	Neg	+	Neg	Neg	Neg	Neg

Apprehension in adduction and IR
Pre-op	Neg	Neg	Neg	Neg	Neg	Neg	Neg	+	Neg
Post-op	Neg	Neg	Neg	Neg	Neg	Neg	Neg	Neg	Neg

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] ^*Corresponding author. E-mail: flavio.franca29@gmail.com (F.O. França).

Brasil

Brasil

Functional outcome after arthroscopic repair of triple shoulder instability☆ ☆ Study conducted at Hospital Lifecenter, Hospital Belo Horizonte, and Hospital Ortopédico, Belo Horizonte, MG, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Functional outcome after arthroscopic repair of triple shoulder instability^{^☆} ☆ Study conducted at Hospital Lifecenter, Hospital Belo Horizonte, and Hospital Ortopédico, Belo Horizonte, MG, Brazil.