There are a few reports about outcomes of positional posterior instability of the shoulder after conservative treatment. The aim of this study was to investigate the clinical outcome of positional posterior instability of the shoulder treated non-operatively by questionnaire. From 1986 to 2003,19 shoulders of 18 patients who were diagnosed as positional posterior instability of the shoulder. The positional posterior instability of the shoulder was diagnosed by Jerk test. There were 7 females and 11 males. Sulcus sign was positive in 9 shoulders, and anterior apprehension test was positive in 3 and posterior apprehension test is positive in 11. Physical therapy including rotator cuff muscle exercise was given to all cases.
Subjective shoulder instability, pain, and restriction of daily living and sports activities were investigated. The average follow-up period was 8.1 years.
In 14 shoulders, instability was not improved, but pain and restriction of ADL were improved.
In 12 of 16 shoulders who had shoulder pain, pain improved after 1.9 years from the First visit to our hospital. They continued physical therapy for an averaged 2.1 years, while 4 shoulders whose symptoms were not improved and only continued muscle exercise for 0.9 years. Shoulder instability did not improve in 12 shoulders that had multidirectional joint laxity. Restriction of daily activities remained in 4 shoulders. Restriction of sports activities continued in 4 shoulders.
On the basis of these outcomes, patients who have positional posterior instability of the shoulder can be treated conservatively with physical therapy, such as rotator cuff exercise more than 2 years before considering surgical treatments.
