Failed anterior reconstruction for shoulder instability. x

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Hawkins RH. Hawkins RJ. x Journal of Bone & Joint Surgery - British 67(5):709-14, 1985 Nov. x We report a retrospective study of 46 patients with continuing x difficulties after anterior reconstruction of a shoulder for instability. x In 31 patients instability was still present; in 12 of these, posterior or x multidirectional instability had not been recognised and a further 11 had x an uncorrected anatomical defect. In 20 patients with significant pain x there was often more than one cause: impingement syndrome was seen in x nine, osteoarthritis in seven, implant irritation in four and instability x alone in two. A disabling medial rotation contracture was seen in 10 x patients, four of whom had painful osteoarthritis. We conclude that x recurrence of symptoms may imply that the direction of the instability was x not recognised, that an anterior repair should not be too tight, and that x pain after successful stabilisation is often due to impingement. x