Nonoperative Management of Posterior Shoulder Instability: What Are the Long-Term Clinical Outcomes?
Clin J Sport Med
; 32(2): e116-e120, 2022 03 01.
Article
en En
| MEDLINE
| ID: mdl-33852434
ABSTRACT
OBJECTIVE:
To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).DESIGN:
A retrospective review of 143 patients with PSI using a large geographic database.SETTING:
Single county between January 1994 and July 2012. PATIENTS A clinical history and diagnosis of PSI, one confirmatory imaging study to support the diagnosis, and a minimum of 5 years follow-up were required for inclusion. Patients with seizure disorders, anterior-only instability, multidirectional instability, and superior labrum from anterior to posterior diagnosis were excluded.INTERVENTIONS:
Patients with PSI were managed nonoperatively or operatively. MAIN OUTCOMEMEASURES:
Pain, recurrent instability, and progression into glenohumeral osteoarthritis at long-term follow-up.RESULTS:
One hundred fifteen patients were identified. Thirty-seven (32%) underwent nonoperative management. Twenty (54%) patients were diagnosed with posterior subluxation, 3 (8%) with a single dislocation, and 7 (19%) with multiple dislocations. Symptomatic progression of glenohumeral arthritis was observed in 8% (3) of patients. Pain improved in 46% (17) of patients and worsened in 19% (7). Recurrent instability and progression to osteoarthritis occurred in 15% (3/20) of patients with a traumatic instability event compared with 0% of atraumatic patients after nonoperative management (P = 0.234). Pain at follow-up was more common in nonoperative than operative patients (P = 0.017).CONCLUSIONS:
Nonoperative management is a viable option for many patients with posterior shoulder instability; however, many may continue to have posterior shoulder pain.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Osteoartritis
/
Luxación del Hombro
/
Articulación del Hombro
/
Luxaciones Articulares
/
Inestabilidad de la Articulación
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Clin J Sport Med
Asunto de la revista:
MEDICINA ESPORTIVA
Año:
2022
Tipo del documento:
Article