4 longitudinal study of patients with multidirectional nstability of the shoulder with seven - to ten - year follow - up

i m t f f y M t p m c h m h s m R r u e 8 i t d j s he purpose of our study was to evaluate the long-term utcomes of patients with multidirectional instability of he shoulder initially treated with rehabilitation exerises. Sixty-four patients were treated for atraumatic ultidirectional instability of the shoulder between 987 and 1990. Preliminary evaluation was perormed 2 years after initiation of treatment, and final valuation of the patients was performed at a mean of years after initiation of treatment. At the preliminary valuation, 5 patients were lost to follow-up. Of the emaining 59 patients, 20 had undergone surgical reatment for stabilization of their shoulder. Of the 39 onsurgically treated patients, 19 continued to have ignificant pain, and 18 continued to have significant nstability of their shoulder. Of the 59 patients, 28 subectively rated their shoulder condition as better or uch better after conservative treatment. At the final valuation, 2 more patients were lost to follow-up, and additional patient had had surgical treatment. Thus, f the 57 patients available for final follow-up, 36 had eceived nonsurgical care, and 21 had undergone urgical treatment. Of the 36 nonsurgically treated paients, 23 rated their shoulders as good or excellent ith regard to pain, and 17 were good or excellent ith regard to instability. By the modified Rowe gradng scale, 5 of 36 patients had excellent results, and 2 had good results. The remaining 19 patients were ated as having poor results. Only 8 patients reported hat their shoulders were free of all pain and instabilty. Overall, of the entire group of 57 patients evaluted between 7 and 10 years after initiation of care, 7 had a satisfactory outcome from nonsurgical mangement based on stability and Rowe scores, 23 had ood or excellent results with regard to pain, and 20 ubjectively rated their shoulders as good or excellent.