Bilateral shoulder proprioception deficit in unilateral anterior shoulder instability

Hypothesis and background: Proprioception is an important element of shoulder dynamic stability. It has been shown to be affected in cases of capsular or labral injuries of the glenohumeral joint. Therefore, this study was conducted to investigate bilateral shoulder proprioception by active reproduction of joint position both in patients with post-traumatic recurrent unilateral shoulder instability and in normal healthy volunteers. Methods: We compared 41 patients, comprising 11 female and 30 male patients with an average age of 25.6 years (range, 18-39 years), with post-traumatic unilateral anterior shoulder instability with a control group of 27 healthy volunteers with no history of shoulder problems and with normal shoulder function during examination. All patients were examined using a high-accuracy computer-controlled electronic goniometer (Propriometer). The error of active reproduction of joint position (EARJP) was measured in abduction, flexion, external rotation, and internal rotation in both shoulders. Results: We observed a significant deficit in the EARJP in the unstable shoulders within the instability group. Surprisingly, similar results were recorded for the contralateral, unaffected shoulders within this group of patients compared with the control group. Joint acuity increased with higher elevation of the arm position. Conclusion: Unilateral shoulder injuries, resulting in instability, affect proprioception in both shoulders. as demonstrated by an increased FARJP. This is the first report of unilateral shoulder instability coexisting with inferior proprioception in both shoulders. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.