Background:Proprioceptive capabilities play an important role in stability of the shoulder joint.
Hypothesis:Decreased proprioceptive capabilities can improve by surgical repair of shoulder instability.
Study Design:Prospective long-term study.
Methods:The proprioceptive capabilities of 14 patients with recurrent anterior shoulder instability were examined preoperative and with a minimum follow-up of 5 years postoperative using the angle reproduction test. The patients’ data were compared to a healthy control group.
Results:The joint position sense improved significantly in abduction, flexion, and rotation (P< .05). The preoperative difference from the target joint position was 9.3 ° (SD, 4.6 °) for the summarized positions in abduction, 9.1 ° (SD, 4.5 °) in flexion, and 10.1 ° (SD, 5.1 °) in rotation. Postoperatively, it improved to 5.6 ° (SD, 2.9 °) in abduction, 5.6 ° (SD, 2.7 °) in flexion, and 5.0 ° (SD, 1.8 °) in rotation. The joint position sense of the uninvolved contralateral shoulder improved too.
Conclusions:Five years after surgical repair for shoulder instability, the joint position sense improved significantly, to a level of normal, healthy shoulders.
1. Aydin T, Yildiz Y, Yanmis I, et al. Shoulder proprioception: a comparison between the shoulder joint in healthy and surgically repaired shoulders. Arch Orthop Trauma Surg. 2001;121:422-425.
2.
2. Bankart ASB. The pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg. 1938;26:23-29.
3.
3. Barrack RL, Skinner HB, Buckley SL. Proprioception in the anterior cruciate ligament deficient knee. Am J Sports Med. 1989;17:1-6.
4.
4. Blasier RB, Carpenter JE, Huston LJ. Shoulder proprioception: effect of joint laxity, joint position and direction of motion. Orthop Rev. 1994;23:45-50.
5.
5. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop. 1987;214:160-164.
6.
6. Freeman MAR, Dean MRE, Hoffman WF. The etiology and prevention of functional instability of the foot. J Bone Joint Surg. 1965;47B:678-685.
7.
7. Glencross D, Thorton E.Position sense following joint injury. J Sports Med. 1981;21:21-23.
8.
8. Gohlke F, Müller T, Sökeland T, et al. Distribution and morphology of mechanoreceptors in the rotator cuff. J Shoulder Elbow Surg. 1996;5(supp):7272.
9.
9. Guanche CA, Knatt T, Solomonow M, et al. The synergistic action of the capsule and the shoulder muscles. Am J Sports Med. 1995;23:301-306.
10.
10. Jerosch JG. Effects of shoulder instability on joint proprioception. In: Lephart SM, Fu FH, eds. Proprioception and Neuromuscular Control in Joint Stability.Champaign, Ill: Human Kinetics; 2000:247-264.
11.
11. Jerosch JG, Prymka M.Knee joint proprioception in normal volunteers and patients with anterior cruciate ligament tears, taking special account of the effect of a knee bandage. Arch Orthop Trauma Surg. 1996;115:162-166.
12.
12. Jerosch JG, Thorwesten L.Proprioceptive capability of the glenohumeral complex in patients with posttraumatic shoulder instability. Z Orthop. 1998;136:230-237.
13.
13. Jerosch JG, Thorwesten L, Steinbeck J, et al. Proprioceptive function of the shoulder girdle in healthy volunteers. Knee Surg Sports Traumatol Arthroscopy. 1995;3:219-225.
14.
14. Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. Am J Sports Med. 1982;10:329-335.
15.
15. Lephart SM, Kocher MS, Fu FH, et al. Proprioception following ACL reconstruction. J Sports Rehabil. 1992;1:188-196.
16.
16. Lephart SM, Warner JJP, Borsa PA, et al. Proprioception of the shoulder joint in healthy, unstable and surgically repaired shoulders. J Shoulder Elbow Surg. 1994;3:371-380.
17.
17. Machner A, Wissel H, Heitmann D, et al. Changes in proprioceptive capacities of the shoulder joint in ventral shoulder instability: a comparative study before and after arthroscopic labrum refixation. Sportverletz Sportschaden. 1998;12:138-141.
18.
18. Morgan CD, Bodenstab AB. Arthroscopic Bankart suture repair: technique and early results. Arthroscopy. 1996;3:111-122.
19.
19. O’Brien SJ, Neves MC, Arnoczky SP, et al. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med. 1990;18:449-456.
20.
20. Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of the shoulder function. J Shoulder Elbow Surg. 1994;3:347-352.
21.
21. Robinson AP, Tearse DS, Koch B, et al. Mechanoreceptors in capsular and juxta-labral tissue of the human shoulder. Paper presented at: Tenth Open Meeting of the American Shoulder and Elbow Surgeons; February 27, 1994; New Orleans, La.
22.
22. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a longterm end-result study. J Bone Joint Surg. 1978;60A:1-16.
23.
23. Solomonow M, Guanche CA, Wink C, et al. Mechanoreceptors and reflex arc in the feline shoulder. J Shoulder Elbow Surg. 1996;5:139-146.
24.
24. Steinbeck J, Brüntrup J, Greshake O, et al. Neurohistological examination of the inferior glenohumeral ligament of the shoulder. J Orthop Res. In press.
25.
25. Steinbeck J, Jerosch JG. Arthroscopic transgleniod stabilization versus open anchor suturing in traumatic anterior instability of the shoulder. Am J Sports Med. 1997;26:373-377.
26.
26. Tibone JE, Fechter J, Kao JT. Evaluation of a proprioception pathway in patients with stable and unstable shoulders with somatosenory cortical evoked potentials. J Shoulder Elbow Surg. 1997;6:440-443.
27.
27. Vangsness T, Ennis M.Neural anatomy of the human glenoid labrum and shoulder ligaments. Proceedings of the American Academy of Orthopedic Surgeons; February 20-25, 1992; Washington, DC.
28.
28. Warner JJP. The gross anatomy of the joint surface, ligament, labrum and capsule. In: Matsen FA III, Fu FH, Hawkins RJ, eds. The Shoulder: A Balance of Mobility and Stability. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 1993:7-28.
29.
29. Warner JJP, Deng XH, Warren RF, et al. Static capsuloligamentous restraints to superior-inferior translation of the glenohumeral joint. Am J Sports Med. 1992;20:675-685.
