Open revision stabilization surgery for recurrent anterior glenohumeral instability

Fifty patients (average age, 27 years) who underwent revision anterior stab ilization surgery for failed anterior glenohumeral instability procedures w ere retrospectively reviewed. Failure of the original procedure occurred su bsequent to significant trauma in only 17 of 50 shoulders. At revision, 49 shoulders underwent an anteroinferior capsular shift procedure and 23 under went concurrent repair of a Bankart lesion. One shoulder was treated with a coracoid transfer to reconstruct the anteroinferior glenoid. At an average follow-up of 4.7 years (range, 2 to 10), there were 36 excellent and 3 goo d results (78%). Eleven shoulders were considered unsatisfactory (22%); 7 o f these 11 patients had a diagnosis of voluntary dislocation. Ail 17 patien ts who had failed results after significant trauma had excellent results af ter revision surgery. However, only 22 of the 33 patients (67%) with atraum atic recurrent instability achieved excellent or good results after revisio n surgery. This difference was statistically significant. No patients had r adiographic evidence of osteoarthritis at the most recent follow-up. Range of motion, return to function, and glenohumeral stability can be reliably r estored in a high percentage of patients after revision anterior stabilizat ion surgery for glenohumeral instability. However, the results are not as p redictable as for primary surgery. Factors associated with poor results of revision repair included an atraumatic cause of failure, voluntary dislocat ions, and multiple prior stabilization attempts.