Arthroscopic treatment of multidirectional glenohumeral instability: 2-to 5-year follow-up

Purpose: We present the results of a prospective study evaluating arthrosco pic technique in repairing multidirectional glenohumeral instability. Type of Study: Case series. Methods: The 47 patient study group consisted of 26 men and 21 women. Inclusion criteria were multidirectional glenohumeral ins tability diagnosed on physical examination and at arthroscopy, Exclusion cr iteria were unidirectional anterior or posterior instability and prior inst ability operation. Four patients declined to participate in the study. The average age at the time of operation was 30 years (range, 15 to 56 years). The average interval from operation to final evaluation was 35 months (rang e 26 to 67 months). The American Shoulder and Elbow Surgeons (ASES) Shoulde r Index, Constant, Rowe, and UCLA scores were recorded preoperatively and a t final evaluation. Results: Preoperatively, no patients were rated overall as good to excellent according to the Rowe scale; at final follow-up 94% ( 44 of 47 patients) were rated as good to excellent. One patient was conside red a failure of the index operation due to persistent instability and unde rwent a second operative procedure. One patient noted a loss of strength du ring sports, and 2 patients had pain that limited their throwing ability. T he ASES Shoulder Index improved to 94.7 from 45.4 (P =.001). The absolute C onstant score improved to 91.7 from 60 (P =.001). The Rowe score improved t o 93.7 from 14.2 (P =.001). The UCLA total score improved to 33.1 from 17.4 (P =.001). Average passive external rotation at 90 degrees abduction measu red 88.2 degrees. Twenty-two of 26 patients (85%) returned to their desired levels of sports following the operations. Conclusions: Patients with mult idirectional glenohumeral instability have multiple lesions within the shou lder and the surgeon must individualize the operative treatment. Arthroscop ic surgery produced successful results in 44 of 47 patients.