Paper 32: Posterior Traumatic Shoulder Instability in Athletes

Abstract

The posterior shoulder instability is not so frequent but often as a part of the multidirectional instability. In these cases conservative treatment provides good results. In cases of trauma associated with posterior labral lesion, isolated posterior instability can occur, and the surgical treatment may be necessary. Evaluate the results of arthroscopic treatment for traumatic posterior shoulder instability. 21 shoulders/20 patients with traumatic posterior instability of the shoulder were treated arthroscopically. The mean age was 29.38 years (20-53), two patients were females and 18 males. All patients were involved in sports activities. The main complaint was the sensation of pain and giving way of the shoulder during sports activity. All patients had posterior labram injuries confirmed by MRI. The surgery was performed after failure of conservative treatment for three months. The patients underwent arthroscopic treatment on beach chair. The rehabilitation program consisted of postoperative immobilization for 3 weeks in sling in neutral rotation followed by physiotherapy. The return to sport was allowed after 5 months. We used an average of 2.76 anchors (2-4) for repair. The average follow-up was 28.47 months (12-70). There was improvement in symptoms of pain and feeling of instability in all patients. We found limited external rotation of 5 degrees in two patients, and 10 degrees in two other patients. One of the patient (4.76%) with 10 degrees of external rotation defict presented light sports limitations (Rowe Score-90). All the others patients(95.24%) returned to the sport without limitations. The arthroscopic treatment for traumatic posterior shoulder instability offers satisfactory results in the majority of cases (95.24%), with improvement of symptoms and allowing the return to activities. The limitation of external rotation (less than 10 degress) does not cause significant functional activities deficits.