TY - JOUR
T1 - Nonoperative Management of Posterior Shoulder Instability
T2 - What Are the Long-Term Clinical Outcomes?
AU - Lee, Julia
AU - Woodmass, Jarret M.
AU - Bernard, Christopher D.
AU - Leland, Devin P.
AU - Keyt, Lucas K.
AU - Krych, Aaron J.
AU - Dahm, DIane L.
AU - Camp, Christopher L.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Objective:To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).Design:A retrospective review of 143 patients with PSI using a large geographic database.Setting:Single county between January 1994 and July 2012.Patients:A clinical history and diagnosis of PSI, one confirmatory imaging study to support the diagnosis, and a minimum of 5 years follow-up were required for inclusion. Patients with seizure disorders, anterior-only instability, multidirectional instability, and superior labrum from anterior to posterior diagnosis were excluded.Interventions:Patients with PSI were managed nonoperatively or operatively.Main Outcome Measures:Pain, recurrent instability, and progression into glenohumeral osteoarthritis at long-term follow-up.Results:One hundred fifteen patients were identified. Thirty-seven (32%) underwent nonoperative management. Twenty (54%) patients were diagnosed with posterior subluxation, 3 (8%) with a single dislocation, and 7 (19%) with multiple dislocations. Symptomatic progression of glenohumeral arthritis was observed in 8% (3) of patients. Pain improved in 46% (17) of patients and worsened in 19% (7). Recurrent instability and progression to osteoarthritis occurred in 15% (3/20) of patients with a traumatic instability event compared with 0% of atraumatic patients after nonoperative management (P = 0.234). Pain at follow-up was more common in nonoperative than operative patients (P = 0.017).Conclusions:Nonoperative management is a viable option for many patients with posterior shoulder instability; however, many may continue to have posterior shoulder pain.
AB - Objective:To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).Design:A retrospective review of 143 patients with PSI using a large geographic database.Setting:Single county between January 1994 and July 2012.Patients:A clinical history and diagnosis of PSI, one confirmatory imaging study to support the diagnosis, and a minimum of 5 years follow-up were required for inclusion. Patients with seizure disorders, anterior-only instability, multidirectional instability, and superior labrum from anterior to posterior diagnosis were excluded.Interventions:Patients with PSI were managed nonoperatively or operatively.Main Outcome Measures:Pain, recurrent instability, and progression into glenohumeral osteoarthritis at long-term follow-up.Results:One hundred fifteen patients were identified. Thirty-seven (32%) underwent nonoperative management. Twenty (54%) patients were diagnosed with posterior subluxation, 3 (8%) with a single dislocation, and 7 (19%) with multiple dislocations. Symptomatic progression of glenohumeral arthritis was observed in 8% (3) of patients. Pain improved in 46% (17) of patients and worsened in 19% (7). Recurrent instability and progression to osteoarthritis occurred in 15% (3/20) of patients with a traumatic instability event compared with 0% of atraumatic patients after nonoperative management (P = 0.234). Pain at follow-up was more common in nonoperative than operative patients (P = 0.017).Conclusions:Nonoperative management is a viable option for many patients with posterior shoulder instability; however, many may continue to have posterior shoulder pain.
KW - nonoperative treatment
KW - posterior labral tear
KW - posterior labrum
KW - posterior shoulder dislocation
KW - posterior shoulder instability
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U2 - 10.1097/JSM.0000000000000907
DO - 10.1097/JSM.0000000000000907
M3 - Article
C2 - 33852434
AN - SCOPUS:85123829792
SN - 1050-642X
VL - 32
SP - E116-E120
JO - Clinical Journal of Sport Medicine
JF - Clinical Journal of Sport Medicine
IS - 2
ER -