Abstract
BackgroundNo previously published studies have examined recurrent traumatic incomplete events in patients with excessive joint laxity. The purpose of this study is to investigate outcomes after arthroscopic stabilization for recurrent traumatic shoulder subluxation in patients with excessive joint laxity but no history of dislocation.MethodsThis study included 23 patients with glenoid bone defects less than 20% who underwent arthroscopic stabilization of recurrent shoulder subluxation and were available for at least 2 years follow-up. Outcomes were assessed with the subjective shoulder value (SSV), University of California Los Angeles (UCLA) shoulder score, Rowe score, and sports/recreation activity level.ResultsPostoperatively, overall functional scores improved significantly (p < 0.001), compared to preoperative scores: SSV improved from 49.1 to 90.4; Rowe score improved from 36.7 to 90.2; and UCLA shoulder score improved from 26.3 to 32.5. Patient satisfaction rate was 87% (20/23 patients). Sports/recreation activity level (return to premorbid activity level; grade I = 100% to grade IV = less than 70%) was grade I in 7 patients, grade II in 11, grade III in 3, grade IV in 2. The incidence of any glenoid bone defect was 61% (14/23 patients), and the mean glenoid bone defect size was 8%; among these 14 patients, 8 (35%) exhibited 15–20% glenoid bone defects. Instability reoccurred in 2 patients (9%) who had 15–20% glenoid bone defect.ConclusionDespite excessive joint laxity, overall functional outcomes after arthroscopic stabilization of recurrent shoulder subluxation were satisfactory. However, arthroscopic Bankart repair may not be reliable in patients with excessive joint laxity plus a glenoid bone defect size of more than approximately 15%.
Highlights
No previously published studies have examined recurrent traumatic incomplete events in patients with excessive joint laxity
A concomitant type II Superior labrum anterior to posterior (SLAP) lesion was identified in 4 of the 23 patients (19%), which was repaired with suture anchors
In the remaining three patients, anteroinferior labrum was incompletely torn and cracked (Fig. 1), but this differed from a typical Bankart lesion; in these patients, Bankart repair was not performed, but capsular shift and plication were performed with three non-absorbable sutures alone
Summary
No previously published studies have examined recurrent traumatic incomplete events in patients with excessive joint laxity. The purpose of this study is to investigate outcomes after arthroscopic stabilization for recurrent traumatic shoulder subluxation in patients with excessive joint laxity but no history of dislocation. The recurrent episodes, in turn, In some patients, the initial trauma episode and later recurrent episodes do not require manual reduction, and the shoulder reduces itself. This is likely in patients with excessive joint laxity. We postulate that in these patients, the initial and subsequent episodes are not true dislocations, but subluxations, the patient might think that his or her shoulder popped out and in spontaneously.
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