Der Einfluss der Hyperlaxität auf die Ergebnisse offener Stabilisierungsoperationen bei posttraumatischen Schulterinstabilitäten

Abstract

Chronic post-traumatic shoulder instabilities as well as post-traumatic shoulder instabilities in association with joint laxity are accepted reasons for open capsular shift and labral refixation. However, it remains unclear whether hyperlaxity influences clinical outcome and reluxation rates. A total of 60 patients (48 men and 12 women) with diagnosed post-traumatic anterior glenohumeral instability were included in the study. Average follow-up was 3.6 ± 0.2 years (median 3.1 years, minimum 2 years, maximum 8 years). 37 patients (61 %) had a joint hyperlaxity grade II or more. In 77 % of the cases glenoid osseus defects were observed (< 20 % of the glenoid fossa). Three cases of shoulder dislocations (5 %) recurred after surgery, following a massive trauma during sports activities. One patient was excluded from the study due to other reasons. The average Rowe scores were 88.7 points. No significant differences were observed between patients with and without concomitant hyperlaxity. From 56 patients without postoperative redislocations 55.2 % had a very good, 34 % a good, and 10.3 % a satisfactory result (Rowe score). The relative constant score and force measurement values were significantly lower in hyperlax shoulders. The average loss of external rotation was 3.9 degrees with the arm at the side and 11 degrees with the arm in 90 degrees of abduction. Our study shows that hyperlaxity does not lead to a higher redislocation rate following open anatomic refixation of the capsule-labrum complex in combination with a capsular shift.