Orthopaedic Surgery Fellow, Clinique du Sport Bordeaux, 4, rue Négrevergne, 33700 Mérignac, France; Orthopaedic Surgery, Sousa Martins Hospital, City of Guarda, Portugal; Faculdade de Ciências da Saúde, Universidade da Beira Interior, City of Covilhã, Portugal.
Centre de chirurgie orthopédique et sportive, clinique du sport de Bordeaux-Mérignac, 2, rue Nègrevergne, 33700 Mérignac, France.
Orthop Traumatol Surg Res. 2017 Dec;103(8S):S185-S188. doi: 10.1016/j.otsr.2017.08.004. Epub 2017 Sep 2.
The management of posterior shoulder instability remains controversial. Consequently, for a symposium on this topic, the French Arthroscopy Society (SFA) conducted a prospective multicentre study comparing outcomes of operative and non-operative treatment.
To compare outcomes after operative versus non-operative treatment of posterior shoulder instability.
The surgical treatment of posterior shoulder instability may achieve better clinical outcomes than non-operative treatment in selected patients.
Fifty-one patients were included prospectively then followed-up for 12months. Three groups were defined based on the clinical presentation: recurrent dislocation or subluxation, involuntary instability or voluntary instability that had become involuntary, and shoulder pain with instability. Of the 51 patients, 19 received non-operative therapy involving a three-step rehabilitation programme and 32 underwent surgery with a posterior bone block, labral repair and/orcapsule tightening, or bone defect filling. At inclusion and at last follow-up, the Subjective Shoulder Value (SSV), Rowe score, Walch-Duplay score, and Constant score were determined.
The preliminary results after the first 12 months are reported here. In the non-operative and operative groups, the Constant score was 78 versus 87, the Rowe score 64 versus 88, and the Walch-Duplay score 69 versus 82, respectively. These differences were statistically significant (P<0.05).
To our knowledge, this study is the first comparison of non-operative versus operative treatment in a cohort of patients with documented posterior shoulder instability. Outcomes were better with operative treatment. However, this finding remains preliminary given the short follow-up of only 1 year.
III, case-control study.
对于肩关节后向不稳定的治疗仍然存在争议。因此，针对这一主题，法国关节镜学会（SFA）进行了一项前瞻性多中心研究，比较了手术和非手术治疗的结果。
比较手术与非手术治疗肩关节后向不稳定的结果。
对于特定患者，手术治疗肩关节后向不稳定可能比非手术治疗获得更好的临床结果。
前瞻性纳入 51 例患者，并进行了 12 个月的随访。根据临床表现将患者分为三组：复发性脱位或半脱位、非自愿性不稳定或已变为非自愿性的自愿性不稳定，以及伴不稳定的肩部疼痛。51 例患者中，19 例接受了包括三步康复计划的非手术治疗，32 例接受了手术治疗，包括后骨块、盂唇修复和/或囊紧缩或骨缺损填充。纳入时和末次随访时，评估患者的主观肩部值（SSV）、Rowe 评分、Walch-Duplay 评分和 Constant 评分。
报告了最初 12 个月后的初步结果。在非手术组和手术组中，Constant 评分为 78 分与 87 分，Rowe 评分为 64 分与 88 分，Walch-Duplay 评分为 69 分与 82 分，差异均有统计学意义（P<0.05）。
据我们所知，这是首次对有记录的肩关节后向不稳定患者的非手术与手术治疗进行比较的研究。手术治疗的结果更好。然而，由于仅随访 1 年，这一发现仍为初步结果。
III 级，病例对照研究。
