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      Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

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          Abstract

          Background:

          Glenohumeral instability is a common abnormality, especially among athletes. Previous studies have evaluated outcomes after arthroscopic stabilization in patients with anterior or posterior shoulder instability but have not compared outcomes between groups.

          Purpose:

          To compare return-to-sport and other patient-reported outcomes in patients after primary arthroscopic anterior, posterior, and combined anterior and posterior shoulder stabilization.

          Study Design:

          Cohort study; Level of evidence, 3.

          Methods:

          Patients who underwent primary arthroscopic anterior, posterior, or combined anterior and posterior shoulder stabilization were contacted at a minimum 2-year follow-up. Patients completed a survey that consisted of return-to-sport outcomes as well as the Western Ontario Shoulder Instability Index (WOSI), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Sur’geons (ASES) score, and Shoulder Activity Scale.

          Results:

          A total of 151 patients were successfully contacted (anterior: n = 81; posterior: n = 22; combined: n = 48) at a mean follow-up of 3.6 years. No significant differences were found between the groups with regard to age at the time of surgery or time to follow-up. No significant differences were found between the groups in terms of WOSI (anterior: 76; posterior: 70; combined: 78; P = .28), SANE (anterior: 87; posterior: 85; combined: 87; P = .79), ASES (anterior: 88; posterior: 83; combined: 91; P = .083), or Shoulder Activity Scale (anterior: 12.0; posterior: 12.5; combined: 12.5; P = .74) scores. No significant difference was found between the groups in terms of the rate of return to sport (anterior: 73%; posterior: 68%; combined: 75%; P = .84).

          Conclusion:

          Athletes undergoing arthroscopic stabilization of anterior, posterior, or combined shoulder instability can be expected to share a similar prognosis. High patient-reported outcome scores and moderate to high rates of return to sport were achieved by all groups.

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          Most cited references26

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          The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario Shoulder Instability Index (WOSI).

          The purpose of this study was to develop a valid, reliable, and responsive disease-specific quality of life measurement tool for patients with shoulder instability. Development included 1) identification of a specific patient population; 2) generation of issues specific to the "disease" ("items") from reviewing the literature, interviewing health caregivers, and interviewing patients representing all demographics, disease type and severity, and treatments; 3) item reduction using patient-generated frequency-importance products and correlation matrices; and 4) pretesting the prototype instrument on 2 groups of 10 patients. The final instrument, the Western Ontario Shoulder Instability Index, has 21 items representing 4 domains. The instrument attributes (validity, reliability, and responsiveness) were evaluated. Construct validation demonstrated that this index correlated predictably with other measures. Reliability was very high at 2 weeks and 3 months, and the index was more responsive (sensitive to change) than five other shoulder measurement tools (the Disabilities of the Arm, Shoulder and Hand scale; The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form; the UCLA Shoulder Rating Scale; the Constant Score; and the Rowe Rating Scale), a global health instrument (the SF12), and range of motion. Since the patient's perception of changes in health status is the most important indicator of the success of a treatment, we suggest that this measurement tool be used as the primary outcome measure to evaluate treatments in this patient population, although it can also be used for monitoring patients' progress in clinical practice.
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            Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada.

            There is a lack of high-quality population-based literature describing the epidemiology of primary anterior shoulder dislocation.
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              • Record: found
              • Abstract: found
              • Article: not found

              Results of Arthroscopic Bankart Repair for Anterior-Inferior Shoulder Instability at 13-Year Follow-up.

              Anterior-inferior shoulder instability is a common injury in young patients, particularly those practicing overhead-throwing sports. Long-term results after open procedures are well studied and evaluated. However, the long-term results after arthroscopic repair and risk factors of recurrence require further assessment.
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                Author and article information

                Journal
                Orthop J Sports Med
                Orthop J Sports Med
                OJS
                spojs
                Orthopaedic Journal of Sports Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2325-9671
                03 April 2018
                April 2018
                : 6
                : 4
                : 2325967118763754
                Affiliations
                []Department of Orthopaedic Surgery, Seton Hall–Hackensack Meridian School of Medicine, South Orange, New Jersey, USA.
                []Providence Medical Group, Kansas City, Kansas, USA.
                [§ ]Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.
                [4-2325967118763754] Investigation performed at CU Sports Medicine and Performance Center, Department of Orthopedics, University of Colorado School of Medicine, Boulder, Colorado, USA
                Author notes
                [*] [* ]Matthew J. Kraeutler, MD, Department of Orthopaedic Surgery, Seton Hall–Hackensack Meridian School of Medicine, 400 South Orange Avenue, South Orange, NJ 07079, USA (email: matthewkraeutlermd@ 123456gmail.com ).
                Article
                10.1177_2325967118763754
                10.1177/2325967118763754
                5888826
                29637085
                f56bfecf-1461-4e93-ac68-870e61e7ca4f
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                glenohumeral instability,return to sport,arthroscopic surgery,shoulder stabilization

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