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Functional Outcome of Arthroscopic Stabilization of Shoulder Instability.
Keywords:
Shoulder instability, Arthroscopy, Bankart lesion, Anchor sutures.Abstract
Objective: The objective of this study was to determine the functional outcome of arthroscopic stabilization of anterior shoulder instability using anchor sutures.
Methods: It was a prospective study done at Hand and Upper Limb Surgery (HULS) Center CMH Lahore Medical College, from January 2017 till July 2018. We included 60 patients who underwent arthroscopic stabilization with the help of anchor sutures. Pre-operative assessment included detailed history, physical examination, joint hyper laxity, plain radiographs, MR-arthrogram and in some cases CT scan of the shoulder joint. Post operatively; functional outcome was evaluated by complete examination of both shoulders mobility, Rowe score, Oxford shoulder instability score and Constant score. Comparison was made with the normal one. Data was analyzed with SPSS ver. 21.
Results: Total patients were 60 (57 male and 3 female) and mean age at the time of operation 41.35±13.86 (range17-78) years. Right side was involved in 66.7% and dominant side in 70% patients. All patients were followed for minimum one year and mean follow up was 18.25 ±3.5 (range 11-22 months).At final visit in the follow up the mean Rowe score was 92.48 ±6.5 and 88.3% (53), 8.3% (5), 3.3% (2) belong to excellent, good and fair group respectively. Mean Oxford shoulder instability score was 43.03±5.99 and 83.4% (50), 13.3% (8) and 3.3% (10) belong to excellent, good and fair group respectively. Mean Contant score was 91.7±11.6 and 80% (48), 10% (6) 6.7% (4) and 3.3% (2) belong to excellent, good, fair and poor group respectively.
Conclusion: Arthroscopic shoulder stabilization is an expedient procedure with excellent functional results for recurrent shoulder dislocation. We strongly recommend it for anterior shoulder instability.
References
2. Pavic R,Margetic P,Bernadic RL.Diagnostic value of US,MR and MR arthrography in shoulder instability.Injury 2013;44:26-32.
3. Kraeutler MJ,Aberle NS,Brown CC,Ptasinski JJ,NcCarty EC.Clinical outcome and return to sport after Arthroscopic Anterior,Posterior and combined shoulder stabilization.Orthop J Sports Med 2018;6(4):232-239.
4. Zarezada A,Dehghani M,Rozati AR,Banadaki HS,Shekarchizade N.Comparison of Bristow procedure and Bankart Arthroscopic method as the treatment of recurrent shoulder instability.Advanced Biomedical Research 2014;3:256-260.
5. Balg F, Boileau P.The Instability Severity Index Score: A simple pre operative score to select patients for arthroscopic or open shoulder stabilization.J Bon Joint Surg[Br] 2007;89(11);1470-7.
6. Vavken P,Sadoghi P,Quidde J,Lucas R,Delaney R,Muller AM et al.Immoblization in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation.Journal of Shoulder and Elbow Surgery 2014;23(1):13-9.
7. Barlow JD,Grosel T,Higgins J,Everhart JS,Magnussen Ra.Surgical treatment outcomes after Primary vs Recurrent anterior shoulder instability.Journal of Clinical Orthopaedics and Trauma 2018;65-70.
8. Kowalski TJ,Khan AZ,Cohen JR,Lord EL,Ishmael C,Soohoo NF et al.Open shoulder stabilization:Current trends and 1 year post operative complication.JSES Open Access 201;:1(2):72-8.
9. Kramer JD,Robinson S,Hohn E,Purviance C,Wolf EM.Fixation methods and implants in shoulder stabilization:A historical perspective 2018;15(2):630-5.
10. Karataglis D,Agathangelidis F.Long term outcome of Arthroscopic shoulder instability surgery.The Open Orthopaedic Journal 2017;11:133-138.
11. Skare, Schroder CP, Mowinckel P,Reikeras O,Brox JI.Reliability,Agreement and Validity of the 1988 version of Rowe score.Journal of Shoulder and Elbow Surgery 2011;20(7):1041-9.
12. Constant CR,Gerber C,Emery RJ,Sojbjerg JO,Gohlke F,Boileau P.A review of the Constant Score:Modification and guidelines for its use.Journal of Shoulder and Elbow Surgery 2008;17(2):355-61.
13. Rouleau DM,Faber K,MacDermid JC.Systemic Review of patient-adminstered shouklderr functional scores on instability.Journal of Shoulder and Elbow Surgery 2010;19(8):1121-8.
14. Antunes JP,Mendes A,Prado MH,Moro OP,Miro RL.Athroscopic Bankart repair for recurrent shoulder instability:A Retrospective study of 86 cases.J Orthop 2016;13(2):95-9.
15. Amako M,Arino H,Tsuda Y,Tsuchihara T,Nemoto K.Recovery of shoulder rotational muscle strength after arthroscopic Bankart repair.Orthop J Sports Med 2017;5(9):232-235.
16. Erkocak OF,Yel M.the functional results of Arthroscopic Bankart repair with knotless Anchors for anterior Glenohumeral instability.European Journal of General Medicine 2010;7(2):25-30.
17. Aydin A,Usta M,Topal M,Umur EY,Truncer K,Karsan O.Comparison of open Bankart Versus Modified Bristow operation for the treatment of traumatic recurrent anterior dislocation and capsular laxity of the shoulder.The Eurasian Journal of Medicine 2012;44(3):157-62.
18. Mishra A,Sharma P,Chaudhary D.Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocation of shoulder.Indian Journal of Orthopaedics 2012;46(6):668-74.
19. Castagna A,Markopoulos N,conti M,Delle-Rose G,Papadakou E,Garofalo R.Arthroscopic Bankart suture anchor repair:Radiological and clinical outcome at minimum 10 years follow up.The American Journal of Sports Medicine 2010;38(10):212-6.
20. Plath JE,Feucht MJ,Bangoj R,Martestschlager f,Wortler K,Seppel G et al.Arthroscopic suture anchor fixation of bony Bankart lesions:Clinical outcome,Magnetic Resonance Imaging Results and return to sports. The Journal of Arthroscopy & Related Surgery 2015;31(8):1472-81.
21. Tordjman D,Vidal C,Fontes D.Mid term results of arthroscopic Bankart repair:A review of 31 cases.Orthropaedics & Traumatology:Surgery & Research 3016;102(5):541-8.
22. Kalkar I,Esenyel CZ,Saygili MS,Esenyel A,Gurbuz H.The results of Bankart repair without capsular plication in patients with recurrent traumatic shoulder dislocation. Journal of Orthopaedic Surgery(Hong Kong) 2017;25(1):23-28.
