Do patients with minor shoulder instability have a different outcome from those with recurrent anteroinferior instability?

Depovere, Tom; Pouliart, Nicole

doi:10.1007/s00590-019-02484-6

Cited by 2 publications

(8 citation statements)

References 27 publications

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“…Shoulder pain associated with minor instability of the glenohumeral joint has been discovered in the last decade. 2 , 7 , 10 , 20 , 21 , 22 , 25 Previous articles have proposed a variety of pathologies as possible causes of this shoulder disorder; this may be due to the ambiguity in the definition of the disease. This issue may have made the diagnosis and treatment of this shoulder disorder difficult.…”

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confidence: 99%

Pathology and surgical outcomes of unstable painful shoulders

et al. 2022

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Pathology and surgical outcomes of unstable painful shoulders

et al. 2022

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“…Beliefs regarding the underlying pathology of this disease also differ among experts [5, 9, 12, 17]. Castagna et al and Depovere et al implicated the anatomy of the anterosuperior capsulolabral complex, such as the superior glenohumeral ligament, MGHL, and rotator interval as the main sources of the pathogenesis of this condition; however, they also reported that preoperative imaging is usually not diagnostic [3–5]. Savoie et al suggested that the pathology was an MGHL lesion and repaired it [18].…”

Section: Discussionmentioning

confidence: 99%

“…Depovere et al reported the postoperative results of patients with minor shoulder instability and recurrent anterior shoulder instability [5], in which symptom recovery was slower, and the final functional outcome was worse in patients with minor shoulder instability. In contrast, the present study showed comparable surgical outcomes for anterior labral repair and/or the remplissage procedure between microinstability and classic recurrent anterior shoulder instability, consistent with the findings of Rowe et al [5, 17].…”

Section: Discussionmentioning

confidence: 99%

“…AALR showed comparable surgical outcomes in patients with microinstaand classic recurrent anterior instability. The instability in these disease entities has long been reported; however, the disease agents remain inconclusive [4,5,13,17,18]. Some patients with shoulder pain during overhead activity without instability showed loss of function.…”

Section: Discussionmentioning

confidence: 99%

“…Shoulder instability has traditionally been classified into two subtypes according to the direction of instability as “traumatic unidirectional Bankart lesion, responds to surgery” (TUBS) or “atraumatic, multidirectional, bilateral, responds to rehabilitation, inferior capsular shift, and interval closure” (AMBRII) [15, 21]. However, this classification is not comprehensive enough to explain all types of shoulder instability [2, 5, 13].…”

Section: Introductionmentioning

confidence: 99%

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Microinstability characterised by small and easily overlooked anterior labral or Hill–Sachs lesions can be managed with arthroscopic anterior labral repair

Kim

Park

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Some young individuals present with shoulder pain without a deinite history or complaint of instability. However, careful history taking, physical examination, and high-quality magnetic resonance imaging may reveal evidence of instability of which the patient is unaware. Therefore, a clearer deinition of these ambiguous patients is needed. This study aimed to report the characteristics and surgical outcomes of patients with microinstability compared to those of patients with classic recurrent anterior shoulder instability. Methods From 2005 to 2018, 35 patients with microinstability (group M) underwent arthroscopic anterior labral repair (AALR) and were compared to 35 sex-and age-matched patients with classic recurrent anterior shoulder instability (group C) who also underwent AALR. Baseline characteristics, preoperative apprehension test indings, preoperative imaging for the presence of anterior labral and Hill-Sachs lesions, preoperative and postoperative (over 2 years) range of motion (ROM) and functional scores, inal complications, and patient satisfaction were analysed. ResultsThe most common chief complaints in groups M and C were pain (29/35) and both pain and instability (27/35), respectively. Only pain during the apprehension test was predominant in group M (M vs. C, 27 vs. 1, p < 0.001). High incidence of chronic repetitive injuries (26/35) and acute trauma (28/35) were observed in groups M and C, respectively. Over half of the patients in group M showed anterior labral lesions on magnetic resonance arthrography (MRA, 18/35), and 21 patients had Hill-Sachs lesions on MRA/three-dimensional computed tomography. Finally, 29 patients showed either anterior labral or Hill-Sachs lesions on preoperative imaging. The lesion severity was higher in group C than that in group M. All patients underwent AALR with/without the remplissage procedure, with no signiicant diferences in inal clinical outcomes, complications, and patient satisfaction between the groups. Conclusions Microinstability is diagnostically challenging and can be diagnosed in young patients with ambiguous shoulder pain during motion, without instability. Pain on anterior apprehension test and subtle labral and/or Hill-Sachs lesion on imaging study could be diagnostic clues. This condition can be managed with arthroscopic anterior labral repair with or without the remplissage procedure. The possibility of microinstability in young patients with shoulder pain should always be considered, and small anterior labral or Hill-Sachs lesions should be closely monitored. Level of evidence III.

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Do patients with minor shoulder instability have a different outcome from those with recurrent anteroinferior instability?

Cited by 2 publications

References 27 publications

Pathology and surgical outcomes of unstable painful shoulders

Pathology and surgical outcomes of unstable painful shoulders

Microinstability characterised by small and easily overlooked anterior labral or Hill–Sachs lesions can be managed with arthroscopic anterior labral repair

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