Painful posterior shoulder instability: Anticipating and preventing failure. A study in 25 patients - 19/12/17
, G. Nourissat b , M.B. Hardy c , D. Antonucci d , P. Clavert e , P. Mansat f , A. Godenèche g the
French Arthroscopy Society
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Abstract |
Background |
Painful posterior shoulder instability (PPSI) is the least common of the three clinical patterns of posterior shoulder instability. PPSI is defined as pain combined with anatomical evidence of posterior instability but no instability events.
Material and method |
We studied a multicentre cohort of 25 patients with PPSI; 23 were identified retrospectively and had a follow-up of at least 2 years and 2 patients were included prospectively. Most patients engaged in sports.
Results |
All 25 patients underwent surgery, which usually consisted in arthroscopic capsulo-labral reconstruction. The outcome was excellent in 43% of patients; another 43% had improvements but reported persistent pain. The pain remained unchanged or worsened in the remaining 14% of patients. Causes of failure consisted of a missed diagnosis of shoulder osteoarthritis with posterior subluxation, technical errors, and postoperative complications. The main cause of incomplete improvement with persistent pain was presence of cartilage damage.
Conclusion |
Outcomes were excellent in patients who were free of cartilage damage, bony abnormalities associated with posterior instability (reverse Hill–Sachs lesion, erosion or fracture of the posterior glenoid), technical errors, and postoperative complications.
Le texte complet de cet article est disponible en PDF.Keywords : Posterior shoulder instability, Painful shoulder instability, Capsulo-labral reconstruction, Posterior bone block procedure, Shoulder pain in athletes
Plan
Vol 103 - N° 8S
P. S199-S202 - décembre 2017 Retour au numéro
Article précédent
- Clinical outcomes of posterior bone block procedures for posterior shoulder instability: Multicenter retrospective study of 66 cases
- P. Clavert, E. Furioli, K. Andieu, F. Sirveaux, M.B. Hardy, G. Nourissat, Y. Bouju, J. Garret, A. Godenèche, P. Mansat, the French Arthroscopy Society
- Posterior shoulder instability managed by arthroscopic acromial pediculated bone-block. Technique
- P. Métais, J. Grimberg, P. Clavert, J.-F. Kouvalchouk, F. Sirveaux, G. Nourissat, J. Garret, P. Mansat, A. Godenèche, the French Arthroscopy Society
Bienvenue sur EM-consulte, la référence des professionnels de santé.