ARTHROSCOPIC RECONSTRUCTION OF TRAUMATIC ANTERIOR INSTABILITY OF THE SHOULDER - THE CASPARI TECHNIQUE

In a prospective study, all patients with recurrent traumatic anterior instability of the shoulder were treated by an arthroscopic transglen oid suture reconstruction; 163 consecutive patients were treated durin g the 3-year period of the study. The average number of dislocations p er patient was 11, average age 27 years, and the average preoperative Bankart score 15. All patients underwent reconstruction using the Casp ari technique of arthroscopic suture reconstruction. Of the 163 patien ts, 161 were re-evaluated 36 to 72 months postoperatively. Overall, 14 7 (91%) of the patients rated as satisfactory and 14 (9%) rated as uns atisfactory. The average postoperative Bankart score for all patients was 89. Twenty of 27 patients (76%) younger than age 18 achieved a sat isfactory result. Forth-nine of 54 college-age patients achieved a sat isfactory result. In patients older than 22 years, 97.5% (78 of 80) ac hieved a satisfactory result. In this extensive study, it would appear that the success of this arthroscopic technique is age-related, with younger patients having a less successful result than older patients. Arthroscopic reconstruction with this technique provides results equal to those of the open procedure for patients age 22 years and older an d would provide a success rate of 90% in patients age 18 to 22. Howeve r, it is effective only 74% of the time in patients younger than 18 an d is not indicated for patients in this age range.