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Arthroscopic Findings After Shoulder Dislocation

Department of Orthopaedic Surgery, University of Basel, Basel, Switzerland

André Gächter, MD

Department of Orthopaedic Surgery, University of Basel, Basel, Switzerland

The purpose of this study was to evaluate prospectively the arthroscopic findings of the unstable shoulder, to provide insights into the causes and mechanisms of shoulder instability, and to establish a rationale for using special surgical procedures. Arthroscopic examination was performed on 212 patients who had at least 1 docu mented shoulder dislocation. Of these 212 patients, 184 (87%) patients had anterior glenoid labral tears, 168 (79%) patients had ventral capsule insufficiency, 144 (68%) patients had Hill-Sachs compression fractures, 116 (55%) patients had glenohumeral ligament insuf ficiency, 30 (14%) patients had complete rotator cuff tendon tears, 26 (12%) patients had posterior glenoid labral tears, 14 (7%) patients had superior labrum an terior and inferior lesions. As this prospective study shows, multiple morphologic changes are associated with instability of the glenohumeral joint; there is no single cause for an unstable shoulder. Arthroscopic ex amination of the shoulder before surgery revealed a sig nificant amount of information that would have been un detected without the aid of expensive diagnostic tools. For instance, the labrum and rim of the anteroinferior glenoid showed typical abnormalities corresponding to different entities of anterior instability.

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