Multidirectional hyperlaxity of the shoulder: Results of treatment

We have evaluated the results after rehabilitation and compared this to inf erior capsular shift in patients with multidirectional hyperlaxity (MDH). T he patients (n=35) experienced either instability and/or pain. We divided t he patients into two groups: one group (group A) included patients with MDH and only pain but no symptoms of instability (n=6). All these patients had initial rehabilitation, followed by surgery in four cases. None of the pat ients with only pain (n=6) were satisfied after rehabilitation. Only two ou t of four were satisfied after surgery In the second group (group B) were i ncluded patients who had MDH with both pain and instability. Six patients h ad surgery without prior rehabilitation and 20 patients had initial rehabil itation. Eight of these patients had surgical stabilization after unsuccess ful rehabilitation. Less than half of the patients with MDH and instability (n=20) were satisfied after rehabilitation alone. Twelve of 14 patients we re satisfied after surgery. We conclude that patients with MDH and only pai n are difficult to treat. Patients with MDH and instability respond only mo derately to the exercise program. Surgery, in combination with physiotherap y, should be the initial treatment when instability is the main symptom.