Recurring shoulder instability possibly linked to histopathologic lesions

Gamulin A. 2014. BMC Musculoskelet Disord. doi: 10.1186/1471-2474-15-45

Recently published research from investigators in Switzerland found what they believed is an association between lesions in the subscapularis muscle and recurrent shoulder instability.

“Histopathologic changes within the subscapularis muscle at the time of primary open labral repair and capsulorrhaphy were associated with an increased risk of shoulder instability recurrence,” the investigators wrote.

Five patients among the 35 patients that they retrospectively reviewed at a mean follow-up of 12.9 years (14.3%) had shoulder instability recurrence and each of them had at least one shoulder dislocation. Recurrence was significantly higher in the 12 patients who presented with histopathologic lesions than in the 23 patients who did not have lesions; 33.3% vs. 4.3%; risk difference, 29% [95% CI 1; 57].

Patients without histopathologic changes demonstrated significantly reduced external rotation with their arm at their side and with the shoulder abducted to 90° (ER1; -11.9° and ER2; -14.9°, respectively) on the operated side compared to the contralateral side. In patients who exhibited histopathologic lesions, only ER2 was significantly reduced on the operated side (-8.9°), Axel Gamulin, MD,and colleagues reported.

“Non-anatomical repairs could be an option in these cases,” they wrote. – by Christian Ingram

Disclosure: The authors have no relevant financial disclosures.