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Arthroscopy ; 34(8): 2287-2293, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29804952

RESUMO

PURPOSE: To evaluate the clinical outcomes and recurrence rates of arthroscopic stabilization procedures in young patients who had recurrent anterior shoulder instability with a glenoid bone erosion more than 20%, and to compare with those in patients with a glenoid bone erosion less than 20%. METHODS: A total of 161 patients who underwent an arthroscopic stabilization procedure for recurrent anterior shoulder instability with anterior glenoid bone erosions and at least 2 years of follow-up were included. Patients were divided into 2 groups based on the glenoid defect size (group I [32 patients]: erosion >20%, group II [129 patients]: erosion <20%). The clinical outcomes were compared using the American Shoulder Elbow Surgeons (ASES) score, Rowe score, and sports/recreation activity level between the 2 groups. Postoperative complications including instability recurrence were documented. RESULTS: The mean glenoid defect size was 22.1 ± 2.1% in group I, and 12.2 ± 3.7% in group II. In group I, clinical outcomes were significantly improved after operation (ASES score: 57.9 ± 14.3 at initial, 88.9 ± 6.2 at the last visit, P = .001; Rowe score: 42.1 ± 15.6 at initial, 87.4 ± 7.6 at the last visit, P = .001). These results were inferior to the clinical outcomes of patients in group II (ASES score: 91.5 ± 12.7, P < .001; Rowe score: 89.3 ± 12.4, P = .01). Postoperative recurrences occurred in 5 patients (15.6%) in group I, whereas patients in group II showed 5.4% of recurrence rate (P = .05). Competent recoveries to sports/recreation activity were achieved in 84.4% of patients in group I. CONCLUSIONS: Arthroscopic stabilization procedures for recurrent anterior shoulder instability in young patients with glenoid bone erosions more than 20% showed satisfactory clinical outcomes and recurrence rate, although these results were inferior to those of patients with glenoid erosions less than 20%. Arthroscopic stabilization procedures can be applied as the primary treatment of recurrent anterior shoulder instability with a large glenoid bone erosion for functional restoration and return to previous sports activity level. LEVEL OF EVIDENCE: Level III, retrospective comparative study.


Assuntos
Artroscopia/métodos , Reabsorção Óssea/complicações , Instabilidade Articular/cirurgia , Luxação do Ombro/cirurgia , Articulação do Ombro/cirurgia , Adulto , Artroscopia/reabilitação , Reabsorção Óssea/patologia , Feminino , Humanos , Instabilidade Articular/complicações , Masculino , Complicações Pós-Operatórias , Recidiva , Estudos Retrospectivos , Volta ao Esporte , Escápula/patologia , Luxação do Ombro/complicações , Resultado do Tratamento , Adulto Jovem
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