Glenohumeral joint range of motion and rotator cuff strength following arthroscopic anterior stabilization with thermal capsulorraphy

Study Design: Single-session, posttest only, descriptive analysis of range of motion (ROM) and strength. Objectives: To measure ROM and strength approximately 12 weeks following ar throscopic anterior stabilization of the glenohumeral joint with thermal ca psulorraphy. Background: Treatment of the patient with anterior, unidirectional glenohum eral joint instability often includes surgical stabilization. Current metho ds focus on arthroscopic stabilization and early ROM and strengthening to r estore normal function to the upper extremity. Methods and Measures: Twenty patients diagnosed with unidirectional shoulde r instability (mean age 24.5 years, SD = 8.48) underwent a postoperative re habilitation program following unilateral arthroscopic shoulder stabilizati on with thermal capsulorraphy. Objective testing including ROM and isokinet ic internal rotation (IR) and external rotation (ER) strength at 90, 210, a nd 300 degrees/s was performed 12 weeks postoperatively. Results: Ten patients had a complete return of shoulder flexion ROM at 12 w eeks. There were deficits compared to the noninjured extremity in postopera tive glenohumeral joint mean abduction (9.8 +/- 12.7 degrees), IR (8.4 +/- 15.0 degrees), and ER (13.1 +/- 14.4 degrees). Isokinetic testing showed a complete return of ER strength on the postoperative extremity compared to t he uninjured extremity for 12 patients with a 4% (+/- 21.1%) mean deficit m easured in IR strength at the slowest testing velocity. No significant diff erence was found between extremities in the external/internal rotation rati os. Conclusion: Postoperative rehabilitation emphasizing progressive ROM and ro tator cuff and scapular strengthening has produced favorable results in pat ients 12 weeks postoperatively with respect to glenohumeral joint ROM and I R and ER strength. Further research and follow-up is required to obtain lon g-term outcomes with respect to patient satisfaction and stability of the g lenohumeral joint following this arthroscopic procedure.