Orthopaedic Surgery, Fundación Jiménez Díaz, Madrid, Spain

Epidemiology and Preventive Medicine, Hospital Universitario la Paz, Madrid, Spain

Orthopaedic Surgery, Fundación Jiménez Diaz, Madrid, Spain

Purpose: The goals of this study were to estimate the prevalence of OA in multidirectional in comparison to anterior shoulder instability and to determine which factors correlate with the presence and grade of OA.

Material and Methods: Chondral and synovial abnormalities were prospectively recorded and graded by arthroscopic visualization in 105 patients (88 anterior and 17 multidirectional) scheduled for shoulder stabiization. Difference in the prevalence and correlation between the grade of arthropathy and risk factors were estimated. Topography and severity of articular alterations were analyzed.

Results: 87 (98,8%) patients with anterior instability and 10 (58,8%) patients with multidirectional instability showed synovial or chondral alterations. In the anterior instability group 28 (31%), 55 (62,5%) and 4 (4,5%) obtained a score of mild, moderate and severe dislocation arthropathy respectively. In the multidirectional instability group 2 (11,7%) and 8 (47,1%) patients obtained a score of mild and moderate arthropathy respectively. The age, age at the first episode and the number of dislocations correlated with the grade of osteoarthrosis in the anterior instability group. The most frequent lesions were the Hill-Sachs lesion and fibrillation on the anteroinferior surface of the glenoid.

Conclusion: Dislocation arthropaty is more prevalent and more severe in anterior shoulder instability when compared to multidirectional instability. Trauma and the number of dislocations seem to play an important role in the development of dislocation arthropaty.