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Arthroscopic Repair for Traumatic Posterior Shoulder Instability

Riley J. Williams, III, MD, Sabrina Strickland, MD, Matthew Cohen, David W. Altchek, MD and Russell F. Warren, MD

From the Sports Medicine and Shoulder Service, Hospital for Special Surgery, Cornell University Medical College, New York, New York

Presented at the 27th annual meeting of the AOSSM, Keystone, Colorado, June 2001.

Address correspondence and reprint requests to Riley J. Williams III, MD, 535 East 70th Street, New York, NY 10021

Background: The role of arthroscopic repair in the treatment of posterior shoulder instability remains poorly defined.

Purpose: To evaluate the results of arthroscopic repair of posterior Bankart lesions.

Study Design: Retrospective review.

Methods: Records were reviewed of 27 shoulders (26 patients). All of the patients were male with a mean age of 28.7 years; in all cases symptoms were preceded by a traumatic event. Fourteen of the patients had 2+ to 3+ posterior translation noted under preoperative anesthesia. The posterior capsulolabral complex was found to be detached from the glenoid rim in all cases; bioabsorbable tack fixation was used for repair.

Results: At a mean follow-up of 5.1 years, no patients demonstrated a range of motion deficit. Muscle weakness (grade 4/5) in external rotation was noted in two patients (8%). There was no instability greater than 1+ in the anterior, posterior, or inferior directions. The mean L’Insalata shoulder score was 90.0 ± 13.9. The mean SF-36 physical and mental component scores were 50.4 ± 7 and 53.9 ± 9, respectively. Symptoms of pain and instability were eliminated in 24 patients (92%). Two patients (8%) required additional surgery after arthroscopic repair of the posterior Bankart lesion. Radiographs demonstrated that there had been no progressive glenohumeral joint degeneration.

Conclusions: Arthroscopic repair of the posterior capsulolabral complex is an effective means of eliminating symptoms of pain and instability associated with posterior Bankart lesions of traumatic origin.

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