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KMID : 0361620090440010029
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Journal of the Korean Orthopaedic Association
2009 Volume.44 No. 1 p.29 ~ p.36
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Comparison of Open and Arthroscopic Inferior Capsular Shifts for Multidirectional Instability of the Shoulder
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Yi Jin-Woong
Cho Nam-Su
Son Eun-Seok
Rhee Yong-Girl
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Abstract
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Purpose: To compare outcomes of open and arthroscopic inferior capsular shifts in multidirectional instability of the shoulder and to evaluate the factors affecting the outcomes.
Materials and Methods: We measured outcomes in 81 patients (84 shoulders) receiving open or arthroscopic inferior capsular shifts because of multidirectional instability of the shoulder from February, 1994, to April, 2006. There were 76 males and 8 females. Their mean age was 22 years at the time of surgery. The visual analogue scale (VAS) for pain, shoulder range of motion (ROM), and Rowe scores were evaluated preoperatively and postoperatively.
Results: In open surgery, the VAS for pain was 5.3 preoperatively and 2.1 postoperatively. VAS for instability changed from 4.6 to 1.7, and the average postoperative Rowe score was 83.7. Forward flexion was 173.7˚ preoperatively and 166.1˚ postoperatively. External rotation on the side changed from 75.5˚ to 62.7˚. In arthroscopic surgery, the VAS for pain was 4.6 preoperatively and 1.2 postoperatively. VAS for instability changed from 5.9 to 1.2, and the average postoperative Rowe score was 87.4. Forward flexion was 169.5˚ preoperatively and 171.2˚ postoperatively. External rotation changed from 70.8˚ to 61.4˚.
Conclusion: Arthroscopic surgery was more effective in decreasing pain and conserving forward flexion of the shoulder than open surgery. Postoperative instability appeared to be related with generalized or bilateral shoulder joint laxity. Pain during motion after the operation was more significant during a voluntary subluxator. Low clinical scores were related with the operation on the dominant side or postoperative instability.
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KEYWORD
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Shoulder, Multidirectional instability, Inferior capsular shift
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