Chapter 43 Posterior Stabilization Surgery
Surgical Overview
• The labrum is a fibrocartilaginous structure that, along with the glenohumeral ligaments, attaches to the glenoid. It contributes to glenohumeral stability by increasing the contact area for the humeral head and provides resistance to humeral head translation.
• At HSS, the posterior stabilization is done exclusively arthroscopically.
1 An examination under anesthesia is performed to accurately determine the amount of capsular laxity.
2 The posterior capsulolabral complex is then reattached to the glenoid labrum through an arthroscope, using either suture anchors or biodegradable tacks.
Rehabilitation Overview
• The rehabilitation program following a posterior stabilization generally begins 2 to 4 weeks postsurgery.
• The program emphasizes early, controlled motion so as to avoid contracture and need for excessive passive stretching later in the program.
• Internal rotation and horizontal adduction are avoided during the early phases of the program and then progressed cautiously so as to avoid excessive stress to the posterior capsule.
• The reduced morbidity of the arthroscopic procedure should reduce the risk of range of motion (ROM) loss.
• Throughout the program a full upper extremity strengthening program will be progressed appropriately to prepare the patient for return to functional activity. However, particular emphasis will be placed on the posterior glenohumeral and scapular musculature to further assist in protecting the posterior capsulolabral complex.
• The program is based on the patient returning to sport-specific activities no earlier than 16 weeks post-surgery, with contact sports and overhead activities progressed last.
• Patient education is critical to avoiding reinjury and adversely affecting the surgical procedure.
