The Value of Histopathological and Clinical Characteristics for the Assessment of the Prognosis and the Efficacy of Dynamic Anterior Stabilization Surgical Treatment for Shoulder Instability

Background: Dynamic anterior stabilization (DAS) is a novel surgical technique for treating chronic anteroinferior glenohumeral instability. It presents an alternative to the currently used Bankart and Latarjet procedures, aiming to reduce associated complications and revision surgeries. However, the value of histopathological and clinical characteristics for the assessment of the prognosis and the efficacy of shoulder instability surgical treatment is still poorly understood. Objectives: The aim of this study was to evaluate the clinical effectiveness of DAS for anterior shoulder instability by analyzing clinical and histopathological characteristics. Methods: Twenty patients with anterior shoulder instability were included in the study. The patients underwent clinical assessments before the surgery and 1, 3, and 6 months after surgery. Tissue specimens from the anterior glenoid bone surface and a segment of the long head of the biceps tendon were evaluated after the surgery. Results: Our results demonstrated that the first three months postoperatively were characterized by worse functional outcomes; however, six months after the surgery, the patients demonstrated functional recovery. The extent of preoperative bone osteonecrosis was associated with functional outcomes after 6 months of surgical treatment (p = 0.034; χ² = 0.482), whereas the extent of lymphocyte infiltration was associated with pain severity (p = 0.022; χ² = 0.402). Conclusions: To conclude, our study showed that dynamic anterior stabilization is a clinically effective method, with functional recovery in 6 months. Furthermore, the associations of clinical and histopathological characteristics for the prognosis and assessment of anterior shoulder instability surgical treatment were observed.