Arthroscopic plication for multidirectional instability: 50 patients with a minimum of 2 years of follow-up

Witney-Lagen, Caroline; Hassan, Abdul; Doodson, Anouska; Venkateswaran, Balachandran

doi:10.1016/j.jse.2016.07.015

Cited by 19 publications

(25 citation statements)

References 33 publications

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“…Although a few studies have assessed outcomes after the arthroscopic treatment of MDI, 3,24,29,30 there is significant variation in the definition of MDI, 20 and this diagnosis does not necessarily coincide with concomitant anterior and posterior instability. To our knowledge, no studies have assessed the outcomes specifically of patients undergoing arthroscopic combined anterior and posterior stabilization, making this the first study to do so.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Kraeutler

Aberle

Brown

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Glenohumeral instability is a common abnormality, especially among athletes. Previous studies have evaluated outcomes after arthroscopic stabilization in patients with anterior or posterior shoulder instability but have not compared outcomes between groups.Purpose:To compare return-to-sport and other patient-reported outcomes in patients after primary arthroscopic anterior, posterior, and combined anterior and posterior shoulder stabilization.Study Design:Cohort study; Level of evidence, 3.Methods:Patients who underwent primary arthroscopic anterior, posterior, or combined anterior and posterior shoulder stabilization were contacted at a minimum 2-year follow-up. Patients completed a survey that consisted of return-to-sport outcomes as well as the Western Ontario Shoulder Instability Index (WOSI), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Sur’geons (ASES) score, and Shoulder Activity Scale.Results:A total of 151 patients were successfully contacted (anterior: n = 81; posterior: n = 22; combined: n = 48) at a mean follow-up of 3.6 years. No significant differences were found between the groups with regard to age at the time of surgery or time to follow-up. No significant differences were found between the groups in terms of WOSI (anterior: 76; posterior: 70; combined: 78; P = .28), SANE (anterior: 87; posterior: 85; combined: 87; P = .79), ASES (anterior: 88; posterior: 83; combined: 91; P = .083), or Shoulder Activity Scale (anterior: 12.0; posterior: 12.5; combined: 12.5; P = .74) scores. No significant difference was found between the groups in terms of the rate of return to sport (anterior: 73%; posterior: 68%; combined: 75%; P = .84).Conclusion:Athletes undergoing arthroscopic stabilization of anterior, posterior, or combined shoulder instability can be expected to share a similar prognosis. High patient-reported outcome scores and moderate to high rates of return to sport were achieved by all groups.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Kraeutler

Aberle

Brown

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…At final follow-up, at least 2 years out from surgery, patients with traumatic onsets demonstrated higher scores, fewer subluxations and were significantly more satisfied than those with atraumatic onsets. The Authors of a recent article 21 plication. They did not include patients with labral or capsular lesions; the surgical technique consists of capsular plications of the antero-inferior portion only, using No.…”

Section: Discussionmentioning

confidence: 99%

“…It was not possible to contact two patients. Ten patients (83% of the total) were clinically re-evaluated -7 women and 3 men with a mean age at evaluation of 27.9 years (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and a mean age at surgery of 25.8 years (17-33). All patients had followed specific rehabilitation protocols for at least 6 months obtaining such unsatisfying results to require further surgery.…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic treatment of the atraumatic shoulder instability: a case series with two-year follow-up evaluation

Gervasi

Sebastiani

Cautero

et al. 2019

Muscle Ligaments and Tendons J

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Background: The purpose of this work is to evaluate the results of arthroscopic capsulolabroplasty in patients affected by atraumatic shoulder instability (ASI). Methods: A retrospective review was performed of 10 patients (7 women and 3 men) who underwent arthroscopic treatment of symptomatic ASI. Mean age at evaluation was 27.9 (19-35) years and the mean follow-up was 23.3 (12-37) months. We evaluated recurrence rate, range of movement, apprehension and relocation tests, hyperlaxity, and sport activity. The ASES score, the Rowe score, the Simple Shoulder Test (SST) and Visual Analogue Scale (VAS) were also used as outcomes measure. Results: None of the patients experienced episodes of dislocation or subluxation after surgery. The apprehension and relocation tests produced positive results in 2 patients. Six out of 10 patients reported apprehension with the arm in specific positions. The ASES mean score was 93.4 (55-100); the Rowe mean score was 85.5 (70-100); the SST mean score was 9. 1 (5.8-10). On average, external rotation is reduced by 10° in adduction, and by 8° in abduction in 6 out of 10 patients; internal rotation is reduced on average by 6.6° in abduction with the arm abducted, and was overall limited in 6 out of 10 patients. Conclusions: Arthroscopic capsulolabroplasty ensures excellent results in patients showing atraumatic shoulder instability in terms of recurrence. Still, an underlying insecurity persists and the risk of residual stiffness is tangible. Level of evidence: V.

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“…Most recently, Witney-Lagen et al. 7 performed the largest series in the literature, retrospectively reviewing 50 patients who underwent arthroscopic plication for MDI; the authors had positive results, with 95% of patients experiencing good or excellent postoperative Oxford Instability Scores with an average of improvement from 16.2 preoperatively to 42.5 postoperatively. Moreover, only 2 patients experienced recurrent instability, all patients returned to work, 90% of patients were able to return to the same level of sport, and 47 of 50 patients were satisfied.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, only 2 patients experienced recurrent instability, all patients returned to work, 90% of patients were able to return to the same level of sport, and 47 of 50 patients were satisfied. 7 …”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Pancapsular Shift With Labral Repair for Multidirectional Instability of the Shoulder

Frangiamore

Mannava

Godin

et al. 2017

Arthroscopy Techniques

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Initial treatment of shoulder multidirectional instability (MDI) consists of nonoperative modalities of physical therapy and rehabilitation; if this fails, surgical treatment can become necessary. MDI of the shoulder can be challenging to manage in individuals who fail conservative management. Historically, surgical treatment for MDI has been open capsular plication; however, arthroscopic capsular plication has now become the standard of care, with outcomes similar to the open procedure. The purpose of this article and Video 1 is to describe our arthroscopic technique for pancapsular shift with labral repair.

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Arthroscopic plication for multidirectional instability: 50 patients with a minimum of 2 years of follow-up

Cited by 19 publications

References 33 publications

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

Arthroscopic treatment of the atraumatic shoulder instability: a case series with two-year follow-up evaluation

Arthroscopic Pancapsular Shift With Labral Repair for Multidirectional Instability of the Shoulder

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