Criteria for arthroscopic treatment of anterior instability of the shoulder: a prospective study

J Bone Joint Surg Br. 2005 May;87(5):677-83. doi: 10.1302/0301-620X.87B5.15794.

Abstract

We prospectively evaluated 61 patients treated arthroscopically for anterior instability of the shoulder at a mean follow-up of 44.5 months (24 to 100) using the Rowe scale. Those with post-operative dislocation or subluxation were considered to be failures. Logistic regression analysis was used to identify patients at increased risk of recurrence in order to develop a suitable selection system. The mean Rowe score improved from 45 pre-operatively to 86 at follow-up (p < 0.001). At least one episode of post-operative instability occurred in 11 patients (18%), although their stability improved (p = 0.018), and only three required revision. Subjectively, eight patients were dissatisfied. Age younger than 28 years, ligamentous laxity, the presence of a fracture of the glenoid rim involving more than 15% of the articular surface, and post-operative participation in contact or overhead sports were associated with a higher risk of recurrence, and scored 1, 1, 5 and 1 point, respectively. Those patients with a total score of two or more points had a relative risk of recurrence of 43% and should be treated by open surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy / methods
  • Female
  • Humans
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Prospective Studies
  • Recurrence
  • Regression Analysis
  • Risk Factors
  • Shoulder Dislocation / physiopathology
  • Shoulder Dislocation / surgery
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Sports
  • Treatment Outcome