Arthroscopic surgery on traumatic anterior instability of shoulder / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the principle of arthroscopic surgery and its clinical importance on the traumatic anterior shoulder instability.</p><p><b>METHODS</b>From September 2002 to May 2005, 18 patients with injury history of 15 weeks averagely, were involved in the study. Twelve of the patients had a history of sports injuries, 5 had shoulder injuries during working time, and 1 had a traffic accident. Among them, 18 had shoulder pain, 15 had limitation of range of motion (ROM) of shoulder, 18 had positive apprehension test and 5 had positive speed test. Three patients had Hill-Satch lesion in X-ray. Double contrast CT I degree 1; II degree 15; III degree 2. On arthroscopic view, 18 had anterior glenoid labrum detachment, 4 had anterior capsular laxity, 4 had combined superior labral anterior posterior (SLAP) injury, 3 had free body, 2 had humeral head or glenoid cartilage lesion. Anterior glenoid labrum detachment in 18 patients was reduced and sutured by the fixed anchor technique, 3 had anterior capsule shrinkage, 2 had debridement of frayed long head tendon of biceps, and 2 had reattachment of the long head tendon of biceps outside the capsule. SLAP injuries were sutured in 3 and debridement of frayed superior labrum in 1.</p><p><b>RESULTS</b>All of the patients were followed up with an average of 18 months (10 - 32 months). All the patients felt free of the pain of their shoulder, except one felt shoulder aching after strenuous exercise. The loss of the external-rotation of the operated shoulder was less than 20 degrees in 2 patients and the posterior extension was 10 degrees in 1 patient. One patient had a positive result of Apprehension Sign. UCLA score 14 +/- 3 preoperatively, 32 +/- 5 postoperatively (t = 14.081, P < 0.01). All patients returned to pre-injured sports activities and original work.</p><p><b>CONCLUSIONS</b>Traumatic anterior shoulder instability can obtain good effects when treated with the arthroscopic surgery of shoulder. Complete reduction, and reliable fixation of the anterior glenoid labrum complex is the key point. Fixation with the suture anchor is reliable and makes the operation simple.</p>