Recovery of shoulder strength and proprioception after open surgery for recurrent anterior instability: A comparison of two surgical techniques

Andrew S. Rokito, Maureen Gallagher Birdzell, Frances Cuomo, Matthew J. Di Paola, Joseph D. Zuckerman

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Previous studies have documented a decrease in proprioceptive capacity in the unstable shoulder. The degree to which surgical approach affects recovery of strength and proprioception is unknown. Materials and methods: The recovery of strength and proprioception after open surgery for recurrent anterior glenohumeral instability was compared for 2 surgical procedures. A prospective analysis of 55 consecutive patients with posttraumatic unilateral recurrent anterior glenohumeral instability was performed. Thirty patients (group 1) underwent an open inferior capsular shift with detachment of the subscapularis, and 25 (group 2) underwent an anterior capsulolabral reconstruction. Results: Mean preoperative proprioception and strength values were significantly lower for the affected shoulders in both groups. At 6 months after surgery, there were no significant differences for mean strength and proprioception values between the unaffected and operative sides for group 2 patients. In group 1 patients, however, there were still significant deficits in mean position sense and strength values. Complete restoration of proprioception and strength, however, was evident by 12 months in group 1. Conclusion: This study demonstrates that there are significant deficits in both strength and proprioception in patients with posttraumatic, recurrent anterior glenohumeral instability. Although both are completely restored by 1 year after surgery, a subscapularis-splitting approach allows for complete recovery of strength and position sense as early as 6 months postoperatively. Detachment of the subscapularis delays recovery of strength and position sense for up to 12 months after surgery.

Original languageEnglish (US)
Pages (from-to)564-569
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume19
Issue number4
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

Keywords

  • Anterior instability
  • capsulolabral repair
  • proprioception

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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