Arthroscopic Posterior Capsular Shift for Traumatic Recurrent Unidirectional Posterior Subluxation of the Shoulder

doi:2003.6.1.55

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Clin Shoulder Elb > Volume 6(1); 2003 > Article

Journal of the Korean Shoulder and Elbow Society 2003;6(1):55-56.
DOI: https://doi.org/10.5397/CiSE.2003.6.1.055 Published online June 30, 2003.

Arthroscopic Posterior Capsular Shift for Traumatic Recurrent Unidirectional Posterior Subluxation of the Shoulder

Seung Ho Kim, M.D., Kwon Ick Ha, M.D., Jae Chul Yoo, M.D.*, Yong Seuk Lee, M.D., Hui Dong Lee , M.D.*

Department of Orthopaedic Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, Korea. Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea*

외상으로 인한 재발성 단방향 견관절 후방 아탈구의 관절경을 이용한 후방낭 이동술

김승호, 하권익, 유재철, 이용석, 이희동

성균관대학교 의과대학 삼성서울병원 정형외과학교실, 을지대학교 의과대학 을지병원 정형외과학교실*

Abstract

Background: The purpose of this study was to evaluated results of arthroscopic treatment of the traumatic recurrent unidirectional posterior subluxation. Materials and Methods: We treated twenty-seven patients who had traumatic recurrent unidirectional posterior subluxation of the shoulder by arthroscopic labral repair and posterior capsular shift and prospectively evaluated for a mean of thirty-nine months (range, 24 to 85 months). Patients who had posteroinferior instability, multidirectional instability, atraumatic onset, or revision cases were excluded. There were twenty-five male and two female patients with the mean age of twenty-one years (range, 14 to 33 years). All patients were involved in sports activity. All had a significant traumatic event prior to the onset of the instability. Stability, motion, three objective measurement (UCLA, ASES, and Rowe scores) and two subjective measurements (pain and function visual analogue scale) were evaluated. Results: The most common finding in magnetic resonance image-arthrogram was separation of the posteroinferior labrum without displacement in 9 patients, In arthroscopic examination, all patients had one or more lesions in the posterior inferior labrum and capsule. The most common finding was incomplete stripping of the posterior inferior labrum (18 patients). The posteroinferior capsule subjectively appeared to be stretched in twenty-two patients. At follow-up, all patients had improved shoulder function and scores(p < 0.01). All patients had stable shoulder by subjectivel and objectivel measurements, except one patient who had recurrent subluxation. All but one patient with postoperative recurrence were able to return to their prior sports activity with little or no limitation. Twenty-four patients were graded as having more than 90% of shoulder function. Their were twenty-one excellent, five good, and one fair UCLA scores. Pain sore improved from 4.5 to 0.2 point(p = 0.0001). Mean loss internal rotation was one vertebral level. None had operative complications. Conclusion: In conclusion, treatment outcomes of the traumatic unidirectional recurrent posterior subluxation are consistently reliable with respect to the stability, pain relief, and functional restoration by the arthroscopic posterior capsular shift procedure.

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