Glenohumeral joint range of motion and rotator cuff strength following arthroscopic anterior stabilization with thermal capsulorraphy

Abstract

Study design: Single-session, posttest only, descriptive analysis of range of motion (ROM) and strength.

Objectives: To measure ROM and strength approximately 12 weeks following arthroscopic anterior stabilization of the glenohumeral joint with thermal capsulorraphy.

Background: Treatment of the patient with anterior, unidirectional glenohumeral joint instability often includes surgical stabilization. Current methods focus on arthroscopic stabilization and early ROM and strengthening to restore normal function to the upper extremity.

Methods and measures: Twenty patients diagnosed with unidirectional shoulder instability (mean age 24.5 years, SD = 8.48) underwent a postoperative rehabilitation program following unilateral arthroscopic shoulder stabilization with thermal capsulorraphy. Objective testing including ROM and isokinetic internal rotation (IR) and external rotation (ER) strength at 90, 210, and 300 degrees/s was performed 12 weeks postoperatively.

Results: Ten patients had a complete return of shoulder flexion ROM at 12 weeks. There were deficits compared to the noninjured extremity in postoperative glenohumeral joint mean abduction (9.8 +/- 12.7 degrees), IR (8.4 +/- 15.0 degrees), and ER (13.1 +/- 14.4 degrees). Isokinetic testing showed a complete return of ER strength on the postoperative extremity compared to the uninjured extremity for 12 patients with a 4% (+/- 21.1%) mean deficit measured in IR strength at the slowest testing velocity. No significant difference was found between extremities in the external/internal rotation ratios.

Conclusion: Postoperative rehabilitation emphasizing progressive ROM and rotator cuff and scapular strengthening has produced favorable results in patients 12 weeks postoperatively with respect to glenohumeral joint ROM and IR and ER strength. Further research and follow-up is required to obtain long-term outcomes with respect to patient satisfaction and stability of the glenohumeral joint following this arthroscopic procedure.