Arthroscopic Treatment of Multidirectional Glenohumeral Instability in Young Overhead Athletes



C. Voigt*, 1, 2, A.P. Schulz2, H. Lill1
1 Department of Trauma and Reconstructive Surgery, Friederikenstift Hospital Hannover, Humboldtstrasse 5, D-30169 Hannover, Germany
2 Department of Orthopaedics and Trauma, University Hospital Schleswig Holstein, Campus Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany


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© Voigt et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Friederikenstift Hospital Hannover, Humboldtstrasse 5, D-30169 Hannover, Germany; Tel: +49-511-129-2331; Fax: +49-511-129-2405; E-mail: christine.voigt@ddh-gruppe.de


Abstract

Purpose:

This prospective case series evaluates the outcome, and the return to sports of young overhead athletes with a persistent, symptomatic multidirectional instability (MDI) with hyperlaxity type Gerber B5 treated with an arthroscopic anteroposteroinferior capsular plication and rotator interval closure.

Methods:

9 young overhead athletes (10 shoulders) with the rare diagnosis of MDI (Gerber B5) and an indication for operative treatment, after a failed physiotherapy program were physically examined 3, 6 and 12 months postoperatively by a physical examination, and got a final phone interview after median 39 months.

Results:

At the final follow-up all patients were satisfied; Rowe Score showed 7 “excellent” and “good” results; Constant Score was “excellent” and “good” in 6, and “fair” in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.

Conclusion:

Symptomatic MDI requires an individual indication for surgical treatment after a primary conservative treatment. The described arthroscopic technique stabilizes glenohumeral joint. A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.

Keywords: Shoulder, multidirectional instability, athletes, arthroscopy, capsular shift.