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Recurrent Shoulder Instability After Open Reconstruction in Athletes Involved in Collision and Contact Sports

John M. Uhorchak, MC, USA, COL, Robert A. Arciero, MC, USA, COL, Donald Huggard, MAJ (RET) and Dean C. Taylor, LTC, MC, USA

Keller Army Community Hospital, West Point, New York

Presented at the Tenth open meeting of The American Shoulder and Elbow Surgeons, New Orleans, Louisiana, February 1994.

Address correspondence and reprint requests to COL John M. Uhorchak, MD, Orthopaedic Service, Keller Army Community Hospital, West Point, NY 10996-1197

The purpose of this study was to evaluate the incidence of recurrent instability in a group of young athletes who underwent open shoulder stabilization with a modified Bankart repair and anterior capsulorrhaphy. Recurrent dislocation was defined as an instability episode resulting in complete dislocation requiring manual reduction. Recurrent subluxation was defined as the subjective history of the shoulder "slipping or popping out" or pain and apprehension that caused cessation of athletics for at least 1 day. Sixty-six patients (64 men and 2 women) were included in the study. A collision sport precipitated instability in 53 patients and a contact sport in 13. The average follow-up was 47 months (range, 24 to 72). The average American Shoulder and Elbow Surgeons score was 95 points (range, 71 to 100). The average Rowe score was 80 points (range, 40 to 100). Two patients had experienced recurrent dislocation after surgery (3%). Eight patients (12%) had rare (fewer than three) episodes of postsurgical subluxation. Five patients (8%) had multiple recurrent subluxations after surgery. Postsurgical recurrent instability was significantly associated with preoperative episodes of subluxation. However, all patients with rare subluxation had an excellent functional result.

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