Multidirectional Instability of the Shoulder: A Systematic Review.

摘要: Purpose To analyze outcomes of surgical and conservative treatment options for multidirectional instability (MDI). Methods A systematic review the literature according to Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines was performed. comprehensive search PubMed, MEDLINE, CINAHL, Cochrane, EMBASE, Google Scholar databases using various combinations keywords "shoulder," "multidirectional instability," "dislocation," "inferior "capsulorrhaphy," "capsular plication," shift," "glenoid," "humeral head," "surgery," "glenohumeral," over years 1966 2014 Results Twenty-four articles describing patients with open capsular shift, arthroscopic treatment, or combined management in setting atraumatic MDI shoulder were included. total 861 shoulders 790 The median age 24.3 years, ranging from 9 56 years. dominant side involved 269 (58%) 468 shoulders, whereas nondominant 199 (42%) shoulders. Patients assessed at a follow-up period 4.2 (ranging months 16 years). Fifty-two 253 (21%) undergoing physiotherapy required intervention management, overall occurrence redislocation seen 61 608 (10%) procedures. event occurred 17 226 (7.5%) shift 21 268 (7.8%) plication 12 49 (24.5%) thermal shrinkage, 11 55 (22%) laser-assisted capsulorrhaphy. Conclusions Arthroscopic are best procedures after failure rehabilitative management. shows results comparable shift. Level Evidence IV, I IV studies.