Outcome after different ventral shoulder stabilizing operations with respect to preoperative arthroscopy

The purpose of this prospective study was to determine concomittant lesions of glenohumeral dislocation and their correlation with the outcome,to dete rmine the influence of various stabilizing operation techniques on the outc ome. 106 shoulders [104 patients, 81 men, 23 women, mean age 36 (16-83) yea rs] operated because of shoulder instability after at minimum one shoulder luxation between 1988 to 1995 were evaluated 3 years (0.8-8 years) postoper atively using Constant score. Preoperative arthroscopy was performed to doc ument intraarticular lesions. There were 7 reluxations (5 because of a new accident), mostly after Putti-Platt procedures. The average modified Consta nt Score was 66 (10-85) points (maximum 85). 29 patients (27%) had less tha n 60 points, mostly because of pain and restriction of function,and were ev aluated as poor. Lesions of rotator cuff, long biceps tendon and subscapula ris tendon had a bad prognosis. The severity of arthroscopically found lesi ons correlated with the outcome. Operations with shortening of subscapular' s tendon or using a bone graft gave bad results. Anatomic reconstruction of the labrum-ligament complex in combination with a plasty of the extended c apsule gave best results. Preoperative arthroscopy can determine the extent of different lesions after shoulder luxation which influence the outcome a nd is useful to select the optimal operation technique.