Shoulder function in patients with unoperated anterior shoulder instability.

Abstract

A functional analysis, including Rowe score and measurements of isokinetic peak torque and range of motion of the shoulder, and a subjective assessment were performed in 26 consecutive patients (23 males and 3 females) with unoperated anterior shoulder instability. Patients experienced the initial dislocation at an average age of 23 +/- 8 years and 58% occurred during sports activity. No patient had gone through any controlled rehabilitation program. In this study, an average of 7 years (range, 1 to 28) had passed since the initial dislocation. Fifty-nine percent of the patients complained of markedly reduced ability to perform in sports because of instability, impaired strength, decreased range of motion, and pain induced by activity. The majority (65%) of the patients reported instability only during physical activity. The average Rowe score was 68 +/- 14 on a scale of 100. In comparison with the healthy side, the injured shoulder had a significantly lower isokinetic peak torque during abduction and internal rotation, as well as a reduced range of motion in extension, abduction, and external rotation, but not in flexion. The severity of impairment (Rowe score, deficit in range of motion, and peak torque) was not related to the number of dislocations sustained or to the duration of instability.