Inestabilidad glenohumeral en pacientes mayores de 40 años: lesiones, tratamiento y complicaciones

Abstract

IntroductionRecurrent shoulder dislocation is infrequent after forty years and presents different injuries than younger patients. ObjectiveTo compare injuries and complications after surgery between one group older than forty years of age and another younger group. Material and methodsA review was made o all patients who had undergone arthroscopic surgery due to glenohumeral instability from 1999 until 2011. The mean follow-up was 64 months.The case group consisted of all patients older than 40 years at the time of the surgery (n=21), which was compared with a similar sized control group of randomly selected younger patients (n=27). ResultsThe mean age in the older group was 54 years (SD 11.86), while it was 26 years (SD 5.80) in the younger group.No differences were founded between both groups in labrum injury, Hill-Sachs injury, and bone Bankart lesion (P>.05). Rotator cuff tears were 7.3 times (95% CI; 2.5-21.6) more frequent in the older group (81%) compared to the younger group (P<.05). However, neurological injuries after dislocation were not more frequent in this group.There was no significant difference between the complications after surgery and the age according to the design (P>.05). ConclusionsAnterior recurrent dislocation after forty years of age is usually associated with rotator cuff tears. Arthroscopic treatment of instability was effective with no more postoperative complications.