Inestabilidad posterior de hombro. Resultados de la reconstrucción artroscópica en pacientes sin defectos óseos significativos

Abstract

Abstract:

Objective: We present the results of a case series of patients with posterior shoulder instability without significant bone defects or excessive glenoid retroversion treated with arthroscopic capsule-labral repair with suture anchors.

Methods: Between 2010 and 2019, 18 patients with posterior shoulder instability underwent an arthroscopic capsule-labral repair with suture anchors. All the cases were operated on at the same surgical center by the same surgeon. The patients were 16 men and two women with an average age of 30.5 years (range 19 to 44 years).  With a mean follow up of 64.4 months (range 13-116 months), the patients were clinically evaluated by the Kim, Jerk, and Apprehension tests. Furthermore, the WOSI, ASES, and ROWE scores, X Rays, CT Scans, and MRIs were also used for pre and postoperative assessment. 

Results: We did not find any case of recurrence of instability. At the final follow up, the Kim’s, Jerk, and Apprehension tests were negative in all the patients. The posterior drawer test decreased translation at an average of 2 pluses. The mean WOSI Score risen from 35.2 to 86.5, the ASES from 33.3 to 85.3, and the Rowe from 20.3 to 91.1. Two patients showed moderate to severe degenerative changes at the final X-Rays. The postoperative MRIs of 12 patients demonstrated an anatomic reduction and adequate healing of the posterior labrum.

Conclusions: The arthroscopic repair of the labrum with anchors is a reliable, reproducible, and effective technique that warrants satisfactory results in selected posterior shoulder instability cases without significant glenoid bone loss or excessive retroversion.