Postoperative Evaluation of Patients Submitted to Arthroscopic Repair of Anterior Shoulder Instability

doi:10.1055/s-0039-3402467

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Original Articles, Shoulder and Elbow • Rev. bras. ortop. 55 (3) • May-Jun 2020 • https://doi.org/10.1055/s-0039-3402467 copy

Postoperative Evaluation of Patients Submitted to Arthroscopic Repair of Anterior Shoulder Instability

About the corresp SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To clinically evaluate the results of patients undergoing arthroscopic surgical treatment of anterior shoulder instability.

Methods

A retrospective study of 94 patients. With a minimum follow-up of 24 months, we sought to correlate the characteristics of the patients and the surgery, such as age, gender, type of injury (traumatic or atraumatic) and the patient's position during surgery (lateral decubitus and beach chair) with the results obtained, the recurrence rate, the lateral rotation loss, the residual pain, and the functional scores of Carter-Rowe, University of California at Los Angeles (UCLA), and Constant-Murley.

Results

We observed a recurrent dislocation rate of 11.7%, lateral rotation loss in 37.23% of the patients, and some degree of residual pain in 51.6% of them. We obtained a mean Carter Rowe score of 85.37, representing 86% of good/excellent results. In the UCLA score, we obtained 88% of good/excellent results, similar to those obtained in the Constant-Murley score (86%).

Conclusion

The arthroscopic treatment of the anterior instability of the shoulder presents satisfactory results and low index of important complications, being the method of choice for most patients.

Keywords
arthroscopy; articular instability; shoulder; retrospective studies

Variable	N	%
Gender
Male	74	78.7
Female	20	21.3
Age at surgery (years)
Median value (Q1-Q3)	34 (28-43)
Injury type
Traumatic injury	85	90.4
Atraumatic injury	9	9.6
Position
Beach chair	23	24.5
Lateral recumbency	71	75.5
Carter-Rowe score (points)
Median value (Q1-Q3)	95 (80-100)
University of California at Los Angeles (UCLA) score (points)
Median value (Q1-Q3)	33 (31-35)
Constant-Murley score (points)
Median value (Q1-Q3)	95 (87-100)

Redislocation	N	%
Yes	11	11.7
No	83	88.3
Residual pain
Yes	48	51.1
No	46	48.9
External rotation loss
Yes	35	37.2
No	59	62.8
Apprehension
Yes	23	24.5
No	71	75.5

Variable	n	Median value	Interquartile range			Minimum	Maximum
Age at surgery (years)	94	34	27.8	-	43	17	62
Score (points)
Carter-Rowe	94	95	80	-	100	15	100
University of California at Los Angeles (UCLA)	94	33	31	-	35	23	35
Constant-Murley	94	95	87	-	100	68	100

Variable	With redislocation		Without redislocation		p-value
Gender
Male	9	81.8	65	78.3	0.57
Female	2	18.2	18	21.7	0.57
Age at surgery (years)
Median value (Q1-Q3)	32 (23-38)		34 (28-43)		0.10
Injury type
Traumatic injury	11	100	74	89.2	0.31
Atraumatic injury	0	0	9	10.8	0.31
Surgical position
Beach chair	4	36.4	19	22.9	0.26
Lateral recumbency	7	63.6	64	77.1	0.26

Variable	With residual pain		Without residual pain		p-value
Gender
Male	41	85.4	33	71.7	0.085
Female	7	14.6	13	28.3	0.085
Age at surgery (years)
Median value (Q1-Q3)	32 (25-38)		37 (30-44)		0.016
Injury type
Traumatic injury	43	89.6	42	91.3	0.52
Atraumatic injury	5	10.4	4	8.7	0.52
Surgical position
Beach chair	12	25.0	11	23.9	0.9
Lateral recumbency	36	75.0	35	76.1	0.9

Variable	With external rotation loss		Without external rotation loss		p-value
Gender
Male	29	82.9	45	76.3	0.45
Female	6	17.1	14	23.7	0.45
Age at surgery (years)
Median value (Q1-Q3)	35 (25-44)		34 (28-40)		0.53
Injury type
Traumatic injury	30	85.7	55	93.2	0.20
Atraumatic injury	5	14.3	4	6.8	0.20
Surgical position
Beach chair	6	17.1	17	28.8	0.20
Lateral recumbency	29	82.9	42	71.2	0.20

Variable	With apprehension		Without apprehension		p-value
Gender
Male	19	82.6	55	77.5	0.42
Female	4	17.4	16	22.5	0.42
Age at surgery (years)
Median value (Q1-Q3)	31 (25-40)		34 (28-43)		0.29
Injury type
Traumatic injury	23	100	62	87.3	0.070
Atraumatic injury	0	0	9	12.7	0.070
Surgical position
Beach chair	5	21.7	18	25.4	0.72
Lateral recumbency	18	78.3	53	74.6	0.72

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