Arthroscopic stabilization and capsulorraphy for the treatment of traumatic anterior shoulder instability in skeletally immature patients

Abstract

BackgroundTraumatic instability of the shoulder joint in skeletally immature patients is rare. Recurrent instability is a common complication after traumatic dislocation, especially in younger patients. The purpose of this study was to evaluate the functional outcome of arthroscopic capsulolabral repair in adolescent patients.Materials and methodsOver a period of 5 years, 13 patients (age 13.5-17 years) with traumatic anterior shoulder instability were included in this study. There were 11 male and two female patients with a mean age of 15.1 years at the time of surgery. There were 11 right and two left shoulders involved. Arthroscopic stabilization and capsulorraphy were performed before skeletal maturity and after failure of conservative treatment for 6 months. Functional outcomes were measured using the modified Constant-Murley and Rowe scores preoperatively, 6 weeks, 3, 6 months, and 1 year postoperatively and yearly for 2 additional years.ResultsAt the final follow-up (average 28.8 months), the mean modified Constant-Murley score was 93.8 points (range, 87-100) and the mean Rowe score was 96.1 points (range, 90-100). The mean forward flexion and the external rotation with 90° abducted arm did not change from the preoperative values. Eleven patients (84.6%) returned to their preinjury level of recreational activities or sport. One patient (7.7%) suffered from redislocation 7 months after surgery because of sport injury.ConclusionThis study showed that arthroscopic capsulolabral stabilization and thermal capsulorraphy is a reliable and successful surgical procedure for the treatment of recurrent traumatic anterior shoulder instability in young patients before the completion of skeletal maturity. There were no complications for the biodegradation of anchors or growth disturbance, and so the delay of arthroscopic surgery until skeletal maturity is not preferable.Level of evidenceLevel IV, therapeutic case series.