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. 2021 Sep 3;5(6):960-966.
doi: 10.1016/j.jseint.2021.07.004. eCollection 2021 Nov.

Mid- to long-term results of postoperative immobilization in internal vs. external rotation after arthroscopic anterior shoulder stabilization

Marvin Minkus  1 , Julia Wolke  1 , Doruk Akgün  1 , Markus Scheibel  1   2
Affiliations

Mid- to long-term results of postoperative immobilization in internal vs. external rotation after arthroscopic anterior shoulder stabilization

Marvin Minkus et al. JSES Int. .

Abstract

Background: There is still a disagreement on the postoperative rehabilitation concerning position of immobilization of the shoulder after arthroscopic anterior shoulder stabilization and its influence on the clinical outcome. The aim of this study was to evaluate the clinical results and the recurrence rate after arthroscopic anteroinferior shoulder stabilization and postoperative immobilization in internal rotation vs. external rotation.

Methods: Twenty-five patients (22 male and 3 female, mean age 28.5 years) were included in this prospective nonrandomized cohort study. In group I (11 male, 2 female, mean age 28 years), the postoperative functional immobilization was carried out in internal rotation of 60°, and in group II (11 male, 1 female, mean age 30 years), 15° of external rotation of the arm for 4 weeks in both groups. The clinical follow-up was performed at 2, 4, and 6 weeks as well as at 3, 6, and 12 months postoperatively including assessment of range of motion and functional shoulder scores (Subjective Shoulder Value, Constant score, Rowe score, Walch Duplay score, Melbourne Instability Shoulder Score). Furthermore, shoulder instability was evaluated using the apprehension, relocation, and surprise tests. Mid-term follow-up data were additionally assessed after a minimum of 4 years.

Results: Twenty patients (19 male and 1 female) with an average age of 28 years were followed up for 62 (53-72) months after arthroscopic stabilization. The comparison of both groups showed almost equal results regarding the range of motion without any significant differences (P > .05). The evaluation of the shoulder function scores also showed no significant differences with an average Subjective Shoulder Value of 95% vs. 91%, Constant score of 89 vs. 88 points, Rowe score of 96 vs. 94 points, Walch Duplay score of 86 vs. 89 points, Melbourne Instability Shoulder Score of 96 points, and Western Ontario Shoulder Instability Index of 88% vs. 84% (P > .05). There was no recurrent dislocation in both groups.

Conclusion: The type of immobilization after arthroscopic shoulder stabilization does not influence the clinical results after a mid- to long-term follow-up.

Keywords: Arthroscopic shoulder stabilization; Shoulder immobilization in external rotation; Shoulder immobilization in internal rotation; Shoulder instability.

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Figures

Figure 1
Figure 1
Postoperative immobilization in internal rotation.
Figure 2
Figure 2
Postoperative immobilization in external rotation.
Figure 3
Figure 3
Development of the flexion over time from 2-week to 12-month follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
Figure 4
Figure 4
Development of the ER over time from 2-week to 12-month follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
Figure 5
Figure 5
Development of the Constant score over time from 3-months to 12-month follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
Figure 6
Figure 6
Development of the Rowe score over time from 3-months to 12-month follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
Figure 7
Figure 7
Range of motion at long-term follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
Figure 8
Figure 8
Functional shoulder scores at long-term follow-up after immobilization in IR vs. ER after anterior shoulder stabilization. IR, internal rotation; ER, external rotation.
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