Functional outcomes after surgical treatment of anterior soft-tissue shoulder instability using a minimally invasive anterior approach

Abstract

Introduction. The purpose of this paper is to present and analyze the results of treatment of anterior soft-tissue shoulder instability using an open surgical technique with a minimally invasive anterior approach, as well as to emphasize the benefits of using an open surgical procedure in high-risk patients. Material and Methods. All patients underwent surgery at the Clinic of Orthopedic Surgery and Traumatology in Novi Sad in the period between January 2013 and September 2017. Out of 138 patients undergoing surgery for anterior shoulder instability, 40 patients came for follow-up examination. The average age of subjects was 27 ? 6. Medical history was taken from each patient and the range of motion and muscle strength of the operated shoulder was examined. The subjects filled out a questionnaire regarding the functional status of the operated shoulder, their experience in resuming sports activities, and their subjective feeling of pain. The Constant-Murley score was used to assess the postoperative results. Results. Postoperatively, the mean Constant-Murley score was 90.3 ? 11.5, while 87.5% patients had excellent and good results. Compared to the contralateral uninjured shoulder, there was a statistically significant difference (p < 0.05) in the Constant-Murley score, in external rotation of the abducted shoulder (13.2? ? 10.4?), as well as in shoulder adduction (10.25? ? 9.7?). Out of 35 patients who were athletes, 27 continued to actively engage in sports following the surgical treatment. Four patients had a re-dislocation (10%). Conclusion. Open surgical treatment of the anterior shoulder joint instability using a minimally invasive anterior approach is a reliable, time-tested procedure that provides favorable clinical results in young high-risk contact and overhead athletes with timely diagnosis and surgical care.