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J Shoulder Elbow Surg. 2018 Jul;27(7):1235-1242. doi: 10.1016/j.jse.2018.02.035. Epub 2018 Mar 23.

Early return to baseline range of motion and strength after anterior shoulder instability surgery: a Multicenter Orthopaedic Outcomes Network (MOON) shoulder group cohort study.

Author information

1
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA. Electronic address: joseph-v-buckwalter@uiowa.edu.
2
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
3
Department of Orthopaedics and Rehabilitation, Vanderbilt University, Nashville, TN, USA.
4
Department of Orthopaedics and Rehabilitation, University of Kentucky, Lexington, KY, USA.

Abstract

BACKGROUND:

Patients often return to higher-level activities and sports at 4 to 8 months after anterior shoulder stabilization procedures. It is unknown what percentage of patients have regained normal function at this time frame and what factors predict residual deficits, range of motion (ROM), and strength after anterior shoulder instability surgery.

METHODS:

Ten participating sites throughout the United States enrolled patients in a prospective cohort study including primary, revision, arthroscopic, and open anterior stabilization procedures. Baseline demographic data and patient outcomes questionnaires were collected with initial physical examination, treatment, surgical findings, and surgical repair details. At the 6-month follow-up visit, ROM and strength measurements were collected and compared with preoperative measurements.

RESULTS:

There were 348 patients identified who underwent surgical treatment for anterior shoulder instability. Of these, 259 patients (74.0%) returned to baseline, and 89 (26.0%) did not return to baseline shoulder ROM (≥20° loss of ROM) or strength. A higher Beighton score (P = .01) and number of dislocations (P < .01) were associated with failure to regain baseline ROM and strength at early follow-up. No surgical variables were found to influence return to baseline function, including open vs. arthroscopic surgery, primary vs. revision surgery, and number of suture anchors.

CONCLUSIONS:

By 4 to 8 months postoperatively, 76% of patients return to baseline ROM, 98% return to baseline strength, and 74% return to both baseline ROM and strength. An increased number of dislocations and generalized joint laxity were associated with failure to return to baseline ROM and strength at early follow-up after anterior shoulder instability surgery.

KEYWORDS:

Beighton score; Shoulder instability; dislocations; outcomes; range of motion; return to sports; strength; surgical management

PMID:
29576339
DOI:
10.1016/j.jse.2018.02.035
[Indexed for MEDLINE]

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