Association of Traumatic and Atraumatic Posterior Shoulder Instability With Glenoid Retroversion and Outcomes After Arthroscopic Capsulolabral Repair

Authors:

J Christoph Katthagen, Dimitri S Tahal, Scott R Montgomery, Marilee P Horan, Peter J Millett

Abstract:

Posterior instability of the shoulder joint accounts for approximately 10% of surgically treated shoulder instabilities and is being seen with increasing frequency. Posterior shoulder instability (PSI) can result from numerous causes. In general, a traumatic cause can be distinguished from an atraumatic cause with various acknowledged trauma mechanisms having been described in the literature. However, in clinical outcome studies, the definition of traumatic PSI is often vague and not necessarily linked to the acknowledged mechanisms described in the literature.

Arthroscopic capsulolabral anchor stabilization is the current surgical gold standard for patients with PSI who do not have bone loss and in whom nonoperative treatment has failed. Most studies reporting outcomes of arthroscopic capsulolabral repair have presented results of patient populations with mixed causes of PSI or focused on patients with either traumatic or atraumatic onset. Apart from one study that found inferior outcomes for adolescent patients with atraumatic PSI, little is known about functional outcomes and return to sport after arthroscopic capsulolabral repair for traumatic and atraumatic PSI.16

In the past, some authors have described an association between atraumatic PSI and excessively increased glenoid retroversion (GR). Furthermore, patients with traumatic PSI were shown to have significantly more GR than patients with anterior shoulder instability. In addition, increased GR was recently identified as the most significant risk factor for PSI in young athletes. However, it remains unclear if the degree of GR differs between patients with traumatic onset of PSI and patients with atraumatic onset of PSI.

Therefore, the aim of this study was to compare GR and functional outcomes between patients with traumatic onset of PSI and patients with atraumatic onset of PSI. It was hypothesized that there would be more GR and that functional outcome scores would be significantly lower in patients with PSI that had an atraumatic onset.

For the complete study: Association of Traumatic and Atraumatic Posterior Shoulder Instability With Glenoid Retroversion and Outcomes After Arthroscopic Capsulolabral Repair

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Association of Traumatic and Atraumatic Posterior Shoulder Instability With Glenoid Retroversion and Outcomes After Arthroscopic Capsulolabral Repair

Authors:

Abstract:

About the Author: Peter Millett, MD