Muscle strength and function of shoulders with Bankart lesion after successful arthroscopic treatment: interlimb comparison 24 months after surgery

Arch Orthop Trauma Surg. 2013 Dec;133(12):1711-8. doi: 10.1007/s00402-013-1859-6. Epub 2013 Oct 8.

Abstract

Background: The purpose of this study was to examine outcomes following arthroscopic Bankart repair with the focus on strength after the repair.

Methods: 56 shoulders with Bankart lesion were operated on arthroscopically. Gender, mechanism of the first dislocation, number of dislocations, dominant side, operated side and the number of anchors used for surgery were recorded. DASH and Oxford instability scoring systems were applied preoperatively and compared to scores at the 24-month follow-up. The scoring systems were also applied to contralateral shoulders at the 24th month of follow-up. Range of motion was measured with a goniometer. Muscle strength was analyzed with a dynamometer simultaneously with the muscle activity of four perishoulder muscles. The data were recorded with surface EMG. Range of motion, muscle strength and activity were evaluated according to the contralateral shoulder at the 24th month of follow-up.

Results: Male/female ratio was 42/14 with a mean age of 32 years. The mean number of dislocations was 3 ± 1 and all were traumatic dislocations. The number of mean anchors used was 3.1 and the mean follow-up period was 24 months. In clinical evaluation, the preoperative and postoperative results of the DASH and Oxford instability scores of the unstable shoulders were significantly different. In the comparison between the operated and contralateral shoulders, there was no significant difference in DASH and Oxford instability scores at the 24th month of follow-up. There was no significant loss of range of motion. Only internal rotation strength was significantly reduced and there was no significant change in the EMG patterns.

Conclusions: Although good clinical results can be achieved, internal rotation strength is reduced after arthroscopic surgery, but daily activities are not affected. There is no guarantee for patients of excellent recovery.

Level of evidence: Level III cohort study.

MeSH terms

  • Adult
  • Arthroscopy* / instrumentation
  • Female
  • Humans
  • Joint Instability / surgery*
  • Male
  • Muscle Strength
  • Range of Motion, Articular
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Treatment Outcome