Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleA Comparison of the Spectrum of Intra-articular Lesions in Acute and Chronic Anterior Shoulder Instability
Section snippets
Methods
In our department 127 male patients with traumatic acute and chronic anterior shoulder instability underwent diagnostic and operative arthroscopy of the shoulder joint. All findings were recorded prospectively by use of a special evaluation form. Arthroscopy was performed within 10 days of the first dislocation episode in 23 patients (18.11%), whereas the instability was chronic and recurrent in the rest. Most patients were military cadets, with a mean age at the time of surgery of 23.8 years
Results
Hemarthrosis was evident in all patients with acute dislocation and in 7 patients with chronic laxity who underwent operation soon after a recent dislocation episode. Of the patients, 12 had mild instability (1+), 94 had anterior instability with spontaneous reduction (2+), and 21 had anterior instability with nonreducing dislocation (3+). In both groups the presence of a chondral or osteochondral Hill-Sachs lesion was noted in 112 patients (88.1%), a Bankart lesion was noted in 106 patients
Discussion
The prevalence of glenohumeral joint lesions was described in a series of patients with acute and recurrent anterior shoulder instability. Patients with recurrent shoulder instability had significantly more associated lesions relative to patients with acute dislocations. In both acutely and chronically unstable shoulders, multiple lesions coexist, and these have to be addressed at surgery.
The spectrum of the pathoanatomic lesions encountered in shoulder instability is broad.8, 9, 10, 11, 12, 13
Conclusions
Arthroscopy helps to locate and quantify the associated lesions in patients with anterior shoulder instability. The incidence of shoulder lesions increases with time because the initial dislocation and secondary lesions are more common in patients with chronic instability. In symptomatic, unstable shoulders, early stabilization may be recommended to prevent secondary injuries.
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The authors report no conflict of interest.