Non-operative treatment of multidirectional shoulder instability

At an average follow-up of 3.7 years we assessed the results of non-operati ve treatment of 84 symptomatic shoulders in 59 patients with a diagnosis of multidirectional shoulder instability. Sixty-two shoulders had received no previous surgical treatment (group A) while 22 had failed to respond to su rgical treatment before the rehabilitation programme (group B). Subjectively 11 of the non-operated shoulders (group A) were cured and 27 i mproved, 23 of the shoulders remained the same and one was worse at follow- up. According to the age and gender adjusted Constant score, 38 of the non- operated shoulders had either no disability or only mild disability, nine h ad moderate disability, while the remaining 15 had severe or total disabili ty. These figures were far worse in group B. in group A only four shoulders required operation, while in group B seven required operation following re habilitation. Patients who had had previous shoulder surgery, those with a work related i njury and those with psychological problems were less likely to benefit fro m the rehabilitation programme.