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Arthroscopic stabilization for traumatic posterior shoulder instability with glenoid dysplasia

Authors: A Sinha, L Funk

References: Poster Presentation at BESS 2014

Introduction: 
Glenoid dysplasia is present in about 14% of the population. They are at risk for posterior instability and treatment options are not well defined.

Aim: This study aimed to assess the outcomes of arthroscopic soft tissue posterior labrum reconstruction for traumatic posterior instability in patients with glenoid dysplasia. Patients and Methods: Retrospective review of patients of patients presenting with posterior instability to a tertiary shoulder service over a three year period, with a follow up of more than two years.

Results:
There were six patients (5 male and 1 female) with average age 24 yrs (16 – 46 yrs). All patients had excessive glenoid retroversion and hypertrophy of posterior labrum. All had sustained a traumatic injury of varying severity. All had failed non-operative treatment. MR Arthrogram revealed posterior labral tears on 4 cases. At arthroscopy All had tears of posterior labrum, which were repaired arthroscopically with a large capsular shift. One patient also had a anterior bony Bankart lesion (rugby). Mean follow up was 28 months. Shoulder function and pain showed significant improvement in all patients. All returned to pre-injury level. One patient had recurrent instability after a further traumatic injury. He underwent open posterior soft tissue stabilization and recovered completely. There were no infections or neurovascular complications.

Conclusions:
Arthroscopic posterior shoulder stabilisation is a reliable and safe procedure for traumatic posterior instability in the presence of glenoid dysplasia and retroversion. Corrective bony procedures are not required.


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