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At least 19 recordsLinked to original sources
PubMed1997

[Vienna Shoulder Score (VSS) and Vienna Shoulder Formula (VSF) for follow-up and assessment of shoulder and shoulder girdle injuries].

The Vienna Shoulder Score (VSS) was screened by two groups of patients for use in medical expertises and follow-up examinations. One group (n = 157) consisted of patients with healed clavicular bone fractures, the other group (n = 130) consisted of healthy individuals. The study proved that the VSS is a useful, exact and fast method of shoulder evaluation after injuries to the shoulder and shoulder girdle. The side dominance is of no influence to the outcome of the VSS. The Vienna Shoulder Formula (VSF) helps to equalize the age factor in shoulder examinations.

Activities of Daily Living↗
PubMed2000

Rehabilitation of neck-shoulder pain in women industrial workers: a randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training.

OBJECTIVES: To study whether isometric shoulder endurance was more advantageous than isometric shoulder strength training in reducing pain and perceived exertion and to increase shoulder function through improved muscle endurance and strength. DESIGN: Randomized trial. SETTING: Three occupational health care centers. PARTICIPANTS: Women industrial workers with nonspecific neck-shoulder pain. The International Classification of Diseases, 10th Revision (ICD-10) diagnosis was "cervicobrachial syndrome" (M53.1). Thirty-eight patients completed the isometric shoulder endurance training and 31 patients completed the isometric shoulder strength training. INTERVENTION: Twelve weeks of training. MAIN OUTCOME MEASURES: Self-reported pain and rating of perceived exertion (RPE), arm motion performance test, shoulder muscle strength, shoulder muscle endurance, and shoulder functional tests, as well as follow-up after supervised training had ended. RESULTS: The isometric shoulder strength training resulted in an almost one-scale step decrease in RPE at work and a 5% to 15% improvement of arm motion performance compared with the endurance training. The isometric shoulder strength training more effectively improved left side shoulder abduction strength (p < .026), but no major differences were found for the other strength measurements. The isometric shoulder endurance training was not more successful than the strength training in the endurance test (p .51 to .81). CONCLUSIONS: Physical training programs for neck-shoulder pain may include isometric shoulder muscular strength exercise in addition to isometric shoulder endurance training, rather than endurance training only.

Exercise Therapy↗
PubMed2000

Muscle activation in the contralateral passive shoulder during isometric shoulder abduction in patients with unilateral shoulder pain.

Studies have shown an increased muscle activation at the opposite passive side during unilateral contractions. The purpose of the present study was to examine the influence of pain on muscle activation in the passive shoulder during unilateral shoulder abduction. Ten patients with unilateral rotator tendinosis of the shoulder and nine healthy controls performed unilateral maximal voluntary contractions (MVC) and sustained submaximal contractions with and without subacromial injections of local anaesthetics of the afflicted shoulder. Muscle activation was recorded by electromyography (EMG) from the trapezius, deltoid, infraspinatus and supraspinatus muscles in both shoulders. During MVCs, the EMG amplitude from muscles of the passive afflicted side was not different in patients and controls, and was not influenced by pain alterations. In contrast, the EMG amplitude from the muscles of the passive unafflicted side was lower in the patients and increased after pain reduction. During the sustained submaximal contraction the EMG amplitude increased gradually in the passive shoulder to 15-30% of the EMG amplitude observed during MVC. This response was not influenced by differences in pain. We conclude that muscle activation of the passive shoulder was closely related to the activation of the contracting muscles and thus related to central motor drive, and not directly influenced by changes in pain.

Adult↗
PubMedDate not supplied

Histologic evaluation of the shoulder capsule in normal shoulders, unstable shoulders, and after failed thermal capsulorrhaphy.

BACKGROUND: Attenuation of the shoulder capsule has been noted during revision surgery for failed thermal capsulorrhaphy. HYPOTHESIS: The attenuated capsule seen in patients who have undergone failed thermal capsulorrhaphy will show histologic characteristics distinguishing it from the capsule of normal shoulders and dislocating shoulders. STUDY DESIGN: Case control study. METHODS: The shoulder capsules were studied in 12 patients with traumatic anterior instability and in 7 patients who experienced recurrent instability after a thermal capsulorrhaphy. The capsules of six fresh-frozen cadavers with no shoulder lesions were used as controls. RESULTS: Among patients who had a history of traumatic instability, a denuded synovial layer was present in 58%, subsynovial edema in 58%, increased cellularity in 25%, and increased vascularity in 83%. At the time of surgery, five of seven shoulders in the failed thermal capsulorrhaphy group (71%) were subjectively felt to be thin and attenuated. Denuded synovium was found in 100% of these patients, subsynovial edema in 43%, and changes in the collagen layer in 100%. Changes in the collagen layer in these patients included a "hyalinization" appearance in five cases (71%), increased collagen fibrosis in two cases (29%), and increased cellularity in two cases (29%). CONCLUSIONS: There was no one characteristic observable on histologic evaluation that would explain the attenuation of the capsule in cases of failed thermal treatment. Morphologic collagen structure can be histologically abnormal for up to 16 months after thermal capsulorrhaphy.

Adolescent↗
PubMed2000

Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single-administration reliability and validity.

BACKGROUND AND PURPOSE: Shoulder scales are often used to evaluate treatment efficacy, yet little is known about the psychometric properties of these scales. Only one scale has undergone psychometric scrutiny: the Shoulder Pain and Disability Index (SPADI). This study compared 2 shoulder measures-the University of California-Los Angeles (UCLA) Shoulder Scale and the Simple Shoulder Test (SST)-with the SPADI. SUBJECTS: One hundred ninety-two patients with shoulder disorders were recruited from one physician's office to complete the self-report sections of the 3 scales. METHODS: Cronbach alpha values and standard errors of measurement (SEM) were calculated for each of the multi-item subscales. Validity was examined through calculation of correlation coefficients among the 3 scales. Factor analysis was completed to assess the underlying constructs of the SPADI and the SST. RESULTS: Cronbach alpha values ranged from.85 to.95. The SEM values for the multi-item scales ranged from 4.75 to 11.65. Evidence for validity to reflect function was indicated by the correlation between the SST and the SPADI disability subscale. The factor analysis of the SPADI revealed loading on 1 factor, whereas the SST loaded on 2 factors. CONCLUSION AND DISCUSSION: All scales demonstrated good internal consistency, suggesting that all items for each scale measure the same construct. However, the SEMs for all scales were high. Factor loading was inconsistent, suggesting that patients may not distinguish between pain and function.

Adolescent↗
PubMedDate not supplied

Shoulder-strengthening exercise with an orthosis for multidirectional shoulder instability: quantitative evaluation of rotational shoulder strength before and after the exercise program.

We evaluated the results of shoulder-strengthening exercises with our novel shoulder orthosis to stabilize the scapula in 46 patients with multidirectional shoulder instability. We quantified the changes in muscle strength produced by our rehabilitation program. Our study included 34 female patients and 12 male patients (mean age, 20 years) with 73 affected shoulders. All patients performed the prescribed exercise program for 8 weeks. Their mean total scores on the modified Rowe grading system significantly increased from 51.9 to 74.9 points (P <.001). The mean peak torque of internal and external rotation, measured with an isokinetic dynamometer, significantly increased (P <.05); the mean external/internal peak torque ratios significantly decreased (P <.05) and were normalized upon completion of the rehabilitation program. Because of failure of conservative treatment, 3 patients underwent surgery at a mean follow-up duration of 7 years. We conclude that the prescribed shoulder-strengthening exercise represents a useful treatment option for patients with multidirectional shoulder instability.

Adolescent↗
PubMed2001

Shoulder proprioception: a comparison between the shoulder joint in healthy and surgically repaired shoulders.

Proprioceptive mechanisms appear to play a role in stabilizing the glenohumeral joint and may serve as a means for interplay between the static stabilizers and the dynamic muscle restraints. The aim of this study was to investigate proprioception of the joint in healthy and surgically repaired shoulders. Shoulder proprioception was measured in 44 subjects who were assigned to two experimental groups: group 1, healthy subjects (n = 24); and group 2, patients who have undergone surgical reconstruction (n = 20). Joint position sense was measured with a Cybex NORM isokinetic dynamometer. The results revealed no significant differences in proprioception between the dominant and nondominant shoulders in group 1. No significant mean differences were revealed between the surgical and contralateral shoulder in group 2 under any test condition. These results imply that arm dominance in healthy individuals does not influence the proprioceptive sensibility and that reconstructive surgery appears to restore some of these proprioception characteristics.

Adolescent↗
PubMed2000

Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults.

BACKGROUND: Multidisciplinary biopsychosocial rehabilitation programs for neck and shoulder pain require substantial staff and financial resources. Despite questionable scientific evidence of their effectiveness, they are widely used. Neck and shoulder complaints are common among working age adults and they are often associated with physical work load and stress. Pain in the neck and shoulder area cause biopsychosocial difficulties for the patient especially if disability due to pain is prolonged. To help patients with biopsychosocial problems or to prevent their development, multidisciplinary biopsychosocial programs are applied on rehabilitation for neck and shoulder pain patients. Nevertheless multidisciplinary treatment programmes are often laborious and rather long processes and require good collaboration between the patient, the rehabilitation team and the work place. OBJECTIVES: The objective of this systematic review was to determine the effectiveness of multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. SEARCH STRATEGY: The reviewed studies for this structured Cochrane review were identified from electronic bibliographic databases, the Science Citation Index, reference checking and consulting experts in the rehabilitation field. The original search was planned and performed for more broad area of musculoskeletal disorders. Trials on neck and shoulder pain were separated afterwards. SELECTION CRITERIA: From all references found in our original search we selected randomized controlled trials (RCTs) and non-randomized controlled clinical trials (CCTs). Trials had to assess the effectiveness of biopsychosocial rehabilitation for patients suffering from neck and shoulder pain among working age adults. The rehabilitation program was required to be multidisciplinary, i.e.; it had to consist of a physician's consultation plus either a psychological, social or vocational intervention, or a combination of these. DATA COLLECTION AND ANALYSIS: Four blinded reviewers selected the randomized controlled trials and controlled trials that met the specified inclusion criteria. Two experts in the field of rehabilitation evaluated the clinical relevance and applicability of the findings of the selected studies to actual clinical use. Two other blinded reviewers extracted the data and assessed the main results and the methodological quality of the studies using standardized forms. Finally, a qualitative analysis was performed to evaluate the level of scientific evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation. MAIN RESULTS: After screening 1808 abstracts, and the references of 65 reviews, we found only 2 relevant studies that satisfied our criteria. One of these was considered methodologically low quality randomized controlled trial and the other one was a methodologically low quality controlled clinical trial. The clinical relevance of included studies was satisfactory. The level of scientific evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation was limited for neck and shoulder pain. REVIEWER'S CONCLUSIONS: We conclude that there appears to be little scientific evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation compared with other rehabilitation facilities on neck and shoulder pain. Multidisciplinary rehabilitation is a commonly used intervention for chronic neck and shoulder complaints, therefore we see an urgent need for high quality trials in this field.

Adult↗
PubMed1998

A six-year retrospective analysis of shoulder dystocia and delivery of the shoulders.

OBJECTIVE: To investigate the diagnosis, incidence and management of shoulder dystocia. DESIGN: Retrospective review of all the deliveries between 1988 and 1993 which were coded on the computer data base as 'moderate difficulty with the shoulders' or 'shoulder dystocia'. SETTING: A teaching hospital in the south of England. PARTICIPANTS: The study population consisted of 15,658 women who had cephalic vaginal deliveries of babies weighing > 2.5 kg. The sample consisted of the 257 women reported to have moderate difficulty with the shoulders or shoulder dystocia at delivery. FINDINGS: There was a significant fall in the reported incidence of shoulder dystocia during the period under investigation. Eighty-six (1.1%) of the deliveries between 1988 and 1990 were reported to have been complicated by shoulder dystocia. In 1991 a second option was introduced to allow both shoulder dystocia or moderate difficulties with the shoulders to be coded after delivery. Following this change in categorisation, the incidence of shoulder dystocia was reduced to 30 (0.6%) reported cases in 1992-1993. Over the same period the reported incidence of moderate difficulty rose significantly from 29 (1.1%) in 1992 to 60 (2.4%) in 1993 (P < 0.001). Disparity was noted between the experience of practitioners and contemporary definitions of shoulder dystocia and this was highlighted by the number of reported cases of moderate difficulty. In this study practitioners used the term shoulder dystocia in a general sense to describe a range of difficulties encountered with the delivery of the shoulders and they identified many varied manifestations. In comparison, contemporary literature describes shoulder dystocia as a discrete entity. KEY CONCLUSIONS: Shoulder dystocia is a complex clinical scenario and perceptions of the incidence may be influenced by alterations in the delivery technique and changes in the diagnosis and documentation. IMPLICATIONS FOR PRACTICE: The application of traction may interfere with the normal mechanisms of labour and the spontaneous birth of the shoulders, whilst increasing the risk of trauma to the baby. It may be unnecessary to use such interventions routinely in the care of normal labouring women.

Birth Weight↗
PubMed2002

The Effect of a Neoprene Shoulder Stabilizer on Active Joint-Reposition Sense in Subjects With Stable and Unstable Shoulders.

OBJECTIVE: To compare the effects of shoulder bracing on active joint-reposition sense in subjects with stable and unstable shoulders. DESIGN AND SETTING: Two subject groups, with stable and unstable shoulders, participated in an active joint-reposition test of the shoulder under braced and unbraced conditions. SUBJECTS: Forty subjects (22 men, 18 women; age = 21.85 +/- 3.12 years; height = 173.97 +/- 10.08 cm; weight = 71.27 +/- 11.68 kg) were recruited to participate in this study. Twenty Division I athletes were referred to us for shoulder instability, which was subsequently confirmed with clinical assessment. The remaining 20 subjects were recruited from a similar student population and assessed as having stable shoulders. MEASUREMENTS: Each subject's ability to perceive joint position sense in space was tested by actively reproducing 3 preset angles (10 degrees from full external rotation, 30 degrees of external rotation, and 30 degrees of internal rotation) with and without a shoulder brace. Full, active external-rotation range of motion was assessed before active joint-reposition sense testing. RESULTS: While wearing the shoulder brace, the group with unstable shoulders demonstrated significant improvement in the accuracy of active joint repositioning at 10 degrees from full external rotation in comparison with the stable group. Furthermore, those with unstable shoulders demonstrated significantly less full external rotation than did those with stable shoulders, and the brace reduced full external rotation only for those with stable shoulders. CONCLUSIONS: Our findings suggest that shoulder active joint-reposition sense in subjects with unstable shoulders can be improved at close to maximal external rotation by wearing a shoulder brace. This effect does not appear to be related to restriction of shoulder external rotation.

Journal Article↗
PubMed2002

A comparison of peak power in the shoulder press and shoulder throw.

The ability to generate peak power is central for performance in many sports. Currently two distinct resistance training methods are used to develop peak power, the heavy weight/slow velocity and light weight/fast velocity regimes. When using the light weight/fast velocity power training method it was proposed that peak power would be greater in a shoulder throw exercise compared with a normal shoulder press. Nine males performed three lifts in the shoulder press and shoulder throw at 30% and 40% of their one repetition maximum (1RM). These lifts were performed identically, except for the release of the bar in the throw condition. A potentiometer attached to the bar measured displacement and duration of the lifts. The time of bar release in the shoulder throw was determined with a pressure switch. ANOVA was used to examine statistically significant differences where the level of acceptance was set at p < 0.05. Peak power was found to be significantly greater in the shoulder throw at 30% of 1 RM condition [F, (1, 23) = 2.325 p < 0.051 and at 40% of 1 RM [F, (1, 23) = 2.905 p < 0.05] compared to values recorded for the respective shoulder presses. Peak power was also greater in the 30% of 1 RM shoulder throw (510 +/- 103W) than in the 40% of 1 RM shoulder press (471 +/- 96W). Peak power was produced significantly later in the shoulder throw versus the shoulder press. This differing power reflected a greater bar velocity of the shoulder throw at both assigned weights compared with the shoulder press.

Adult↗
PubMed1990

Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain?

Shoulder pain is a common complaint and shoulder hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the clinical relevance of shoulder hyperostosis we performed a controlled, blind study of 99 hospitalized probands with and without thoracospinal hyperostosis on lateral chest X-rays. The study included grading of the shoulder hyperostosis on the basis of three bilateral standard radiographs, assessing shoulder pain in a standardized way by an interviewer and recording extraskeletal causes of shoulder pain. The prevalence of shoulder hyperostosis was doubled in probands with thoracospinal hyperostosis compared to controls (chi 2 = 5.90, P less than 0.025, n = 99). Shoulder hyperostosis, irrespective of thoracospinal hyperostosis, predisposed to shoulder pain (40% versus 18%, chi 2 = 4.06, P less than 0.05, n = 74). Shoulder hyperostosis in combination with thoracospinal hyperostosis (shoulder DISH) predisposed to shoulder pain to an even greater extent (46% versus 12%, chi 2 = 6.64, P less than 0.01, n = 47). We conclude that shoulder hyperostosis is a radiological finding of potential clinical relevance.

Arthrography↗
PubMed1997

Physical examination of the cervical spine and shoulder girdle in patients with shoulder complaints.

OBJECTIVE: To look for differences in mobility in randomly selected patients without shoulder complaints depending on age, gender and left- or right-handedness; to investigate in the patient group whether specific differences exist, depending on the diagnosis made or the afflicted side; and to detect differences between the findings on the mobility examination of the cervical and cervicothoracic spine in patients with shoulder complaints compared with the healthy population. DESIGN: Comparative study. METHOD: The physical examination findings after inclusion and after 26 wk of 101 shoulder patients were compared with those of 75 randomly selected patients without shoulder complaints and adjusted for age and gender. RESULTS: In the population of patients without shoulder complaints, the mobility in the cervical and upper thoracic spine was found to decrease with aging. Significant differences were found between the healthy and the afflicted population at the time of inclusion as well as after 26 wk, even though the majority of patients felt cured at that time. With all types of shoulder complaints, functional disorders in the shoulder girdle were found in which, at the time of inclusion, the emphasis was on pain and, after 26 wk, on restricted motion. Thus, functional disorders in the cervical spine, the higher thoracic spine and the adjoining ribs are not extrinsic causes of shoulder complaints, but an integral part of the intrinsic causes of shoulder complaints. CONCLUSION: Further study is needed to determine if this finding explains the high recurrence rate of shoulder complaints. It may be advisable to include the treatment of functional disorders of the shoulder girdle in treatment of patients with shoulder complaints.

Aging↗
PubMed1999

Shoulder impingement syndrome in relation to shoulder intensive work.

OBJECTIVES: To analyse the risk of shoulder impingement syndrome relative to shoulder intensive work. METHODS: A cross sectional study of a historical cohort of 1591 workers employed between 1986 and 1993 at a slaughterhouse or a chemical factory. Workers not doing tasks in slaughtering or meat processing constituted the reference group. Intensity of shoulder work in meat processing tasks was assessed by video based observations. Information on shoulder disorders was collected by questionnaire and by physical examinations. Impingement syndrome was diagnosed when shoulder symptoms had been present for at least 3 months during the past year and there were signs of subacromial impingement in the corresponding shoulder at physical examination. Shoulder function was assessed at the same occasion with the Constant scoring technique. Prevalence of shoulder impingement syndrome was analysed according to job title and cumulative exposure. RESULTS: Prevalence ratio for shoulder impingement syndrome was 5.27 (95% confidence interval (95% CI), 2.09 to 12.26) among currently working and 7.90 (95% CI, 2.94 to 21.18) among former slaughterhouse workers. Transformed model based prevalence ratios according to years in slaughterhouse work showed an overall association between cumulative exposure and risk for shoulder impingement syndrome. CONCLUSIONS: This study supports the hypothesis that shoulder intensive work is a risk factor for impingement syndrome of the shoulder. Despite the historical cohort design healthy worker selection may have influenced the exposure-response relation found.

Abattoirs↗
PubMed1994

[Dynamic anterior jerk of the shoulder. A new clinical test for shoulder instability. Preliminary study].

PURPOSE OF STUDY: A new clinical test named "The shoulder anterior jerk test" is proposed to confirm the diagnosis of chronic shoulder anterior instability. MATERIAL: The test combines of a compression force and a translation force, applied along the arm between the humeral head and the glenoid cavity. In so doing, a subluxation of the humeral head is provoked and it is accompanied with a jerk recognised by the patient as his instability. METHODS: Three different populations of patients had been studied: Population A: 28 patients operated on for chronic anterior dislocation, uni or bilateral (32 shoulders), had been tested before the operation, without and under anesthesia. Population B: 100 patients without any problem at the shoulder, had been tested before and under anesthesia done for knee or hip surgery. Population C: 100 young sportive athletes with normal shoulder tested without anesthesia. RESULTS: Population A: The 28 patients suffering from shoulder instability had all a positive shoulder jerk test under anesthesia. Without anesthesia the test had been positive only in 10 cases (30 per cent). The jerk is potentially present for all the patients, but it is disturbed by apprehension. Population B: Among the 200 shoulders tested, 26 shoulders (17 patients) had a positive test under anesthesia (13 per cent). 5 had positive jerk test without anesthesia. Population C: 5 among the 200 shoulders tested had a positive jerk test (2.5 per cent) Under anesthesia the test has a sensitivity of 100 per cent, a specificity of 87 per cent, a positive predictive value of 55 per cent and a negative value of 100 per cent. Without anesthesia, the test has a sensitivity of 31 per cent, a specificity of 97.5 per cent, a positive predictive value of 66 per cent and a negative predictive value of 90 per cent. DISCUSSION: The instability which is shown by the jerk test is in relation with the anterior subluxation of the humeral head in front of the anterior edge of the glenoïd cavity. It reproducts, with a minimal amplitude, the clinical instability which is recognized by the patient. The test is always positive under anesthesia in case of chronic anterior instability, it may confirm pre-operative diagnosis just before the begining of the procedure and may orientate the choice of it. Apprehension is a major obstacle to the research of the jerk, but it is the same with the other classical clinical tests of the shoulder anterior instability. CONCLUSION: The anterior jerk test of the shoulder is thus a test which is able to prove the diagnosis of an anterior instability. The future will permit to confirm its efficiency and will confirm if the test may differenciate anterior and inferior instability with variation of the abduction, as it has been shown in this preliminary study.

Adolescent↗
PubMedDate not supplied

Groningen Manipulation Study. The effect of manipulation of the structures of the shoulder girdle as additional treatment for symptom relief and for prevention of chronicity or recurrence of shoulder symptoms. Design of a randomized controlled trial within a comprehensive prognostic cohort study.

BACKGROUND: We present the design of the Groningen Manipulation Study. This randomized controlled trial is part of the Dutch Shoulder Disability Study, a comprehensive prognostic cohort study on shoulder disorders, with randomized controlled interventions in subcohorts. OBJECTIVE: To evaluate the effectiveness of manipulative treatment of the structures of the shoulder girdle, in addition to standard treatment by the general practitioner for relief of shoulder symptoms and prevention of persistent or recurrent shoulder symptoms. METHODS: A total of 250 patients with shoulder symptoms and a functional limitation of the shoulder girdle will be included from 30 general practices in Groningen, The Netherlands. All participating patients receive standard treatment by the general practitioner and will be randomly allocated to additional manipulative treatment. Evaluation measurements take place 6, 12, 26, and 52 weeks after randomization. CONCLUSION: The short-term primary outcome measure is the proportion of patients with relief of shoulder complaints and the long-term primary outcome is the proportion of patients without persistent or recurrent shoulder symptoms. Dependent and independent variables include a structured medical history, a physical examination of the shoulder and shoulder girdle, and a measure of the mobility of the cervico-thoracic spine with a 6-degree-of-freedom electromagnetic tracking device.

Adult↗
PubMed2003

Shoulder arthroplasty in patients with a prior anterior shoulder dislocation. Results of a multicenter study.

BACKGROUND: Prior reports of shoulder arthroplasty performed for dislocation-induced arthropathy have included only patients who had had a prior stabilizing procedure. The purpose of this study was to report the results of shoulder arthroplasty in all patients with a prior anterior shoulder dislocation, including both those previously treated operatively and those previously treated nonoperatively. METHODS: Fifty-five shoulders undergoing arthroplasty for arthritis following a prior anterior shoulder dislocation were evaluated. Twenty-seven of the shoulders had undergone a prior anterior stabilization procedure. The measures used to evaluate the shoulders included the Constant score, adjusted Constant score, active mobility, subjective satisfaction, radiographic result, and complications. RESULTS: The shoulders were evaluated at a mean of 45.0 months. The Constant score improved from a mean of 30.8 points preoperatively to a mean of 65.8 points at the time of follow-up. The adjusted Constant score improved from a mean of 38.2% to a mean of 79.8%. Active forward flexion improved from a mean of 82.1 degrees to a mean of 138.9 degrees. Active external rotation improved from a mean of 4.0 degrees to a mean of 38.6 degrees. Fifty patients rated the result as good or excellent. Negative prognosticators included an older age at the time of the initial dislocation and a rotator cuff tear. No significant differences in demographic factors, pre-arthroplasty function, post-arthroplasty function, pre-arthroplasty radiographic findings, post-arthroplasty radiographic findings, complication rate, or reoperation rate were noted between the patients treated with a prior operation for the anterior instability and those treated nonoperatively. CONCLUSIONS: This investigation documented the good results obtainable with shoulder arthroplasty for the treatment of arthritis following anterior shoulder instability. In addition, our findings suggest that capsulorrhaphy-induced arthropathy may be indistinguishable from arthritis following nonoperatively treated anterior shoulder instability.

Adolescent↗