A Prospective Study of Functional Outcome of Arthroscopic Labral Repair in Adults for Traumatic Shoulder Instability

Abstract

Introduction: The shoulder joint allows more wide spread range of motion than any other joint in the body, requiring a complex interplay between passive and active stabilizers in order to provide balanced, synchronous motion. However, this extensive range of motion results in a propensity for decreased stability. Recurrent anterior shoulder instability as a result of force to the externally rotated and abducted arm is a common pathology to the glenohumeral joint with consequent treatment options and out comes reported in the orthopedic literature dating back to the early twentieth century. Clinical instability can result from injury to the glenoid labrum. It provides passive stability to the humeral head by increasing the depth of the shallow glenoid fossa and serves as a primary attachment site for the glenohumeral ligaments, joint capsule, and long head of the biceps tendon.

Materials and methods: Collection of data as per the proforma with consent from the patients admitted in orthopedic wards, S.V Medical College, Tirupathi. It is a prospective study including 50 cases and conducted from September 2023 to August 2024. Inclusion criteria were Symptomatic labral tear, Complete tear with Apprehension test positive, Labral tear confirmed by MRI, Recurrent shoulder dislocation and Patients who failed to improve on conservative management like ultrasonic therapy or steroid injection. Exclusion criteria were; neurological problems that affects upper limb, shoulder muscle atrophy or dystrophy, associated bony injuries around shoulder except hill Sachs’s lesion and glenoid bone loss >20.

Results: In the series, 28 cases (56%) were in between the age group of 18-30 years, 16 cases (32%) were in between 31-40 years, 2 case (4%) in between 41-50 years and 4 cases (8%) in between 51-60 years. Recurrent shoulder dislocation is inversely proportional to age of the patients. As age increases chances of recurrent dislocation decreases. In the prospective research study, 46 cases (92%) were male and 4 cases (8%) were female. So Recurrent shoulder dislocation is more common in male as compared to female in my study.

Conclusion: Arthroscopic bankarts repair is gold standard for labral tear due to recurrent shoulder dislocation. Short surgery time, less intra operative and post operative complications are advantages. Associated Hill sach’s Lesion is seen in majority patients of labral tear which should be repair for better functional outcome. Arthroscopic bankart repair led to significantly increased shoulder function among patients.