Arthroscopic treatment of multidirectional glenohumeral instability in young overhead athletes.

PURPOSE

This prospective case series evaluates the outcome, and the return to sports of young overhead athletes with a persistent, symptomatic multidirectional instability (MDI) with hyperlaxity type Gerber B5 treated with an arthroscopic anteroposteroinferior capsular plication and rotator interval closure.

METHODS

9 young overhead athletes (10 shoulders) with the rare diagnosis of MDI (Gerber B5) and an indication for operative treatment, after a failed physiotherapy program were physically examined 3, 6 and 12 months postoperatively by a physical examination, and got a final phone interview after median 39 months.

RESULTS

At the final follow-up all patients were satisfied; Rowe Score showed 7 "excellent" and "good" results; Constant Score was "excellent" and "good" in 6, and "fair" in 1 patient. 7/9 returned to their previous sports, 3/9 at a reduced level.

CONCLUSION

Symptomatic MDI requires an individual indication for surgical treatment after a primary conservative treatment. The described arthroscopic technique stabilizes glenohumeral joint. A return to overhead sports is possible but often at a reduced level; returning to high-performance sports cannot be recommended because of the high risk of reinstability.