Incidence of Axillary nerve injury after arthroscopic shoulder stabilization

Abstract Purpose This retrospective study aimed to investigate the incidence of axillary nerve palsy after arthroscopic shoulder stabilization and to measure the distance between the nerve and capsule in shoulders with a capsular lesion. Methods This study included 2027 shoulders (1909 patients; 1433 males, 476 females; mean age, 32 [13–81] years) subjected to arthroscopic soft-tissue stabilization for recurrent shoulder instability from 2005 to 2017. Exclusion criteria were bone grafting or transfer and preoperative axillary nerve symptoms. We retrospectively reviewed patient records and investigated the incidence and clinical features of axillary nerve palsy. We measured the closest distance between the axillary nerve and capsule on preoperative magnetic resonance images. Results Postoperative axillary nerve palsy occurred in four shoulders (0.2% of all arthroscopic stabilizations). Capsular repair was performed in two shoulders (1.2% of 160 capsular repairs), humeral avulsion of the glenohumeral ligament (HAGL) repair in one shoulder (2% of 47 HAGL repairs), and isolated Bankart repair in one shoulder (0.05% of 1941 Bankart repairs). The closest distance between the nerve and capsule was 3.4±3.2 mm in shoulders with capsule or HAGL lesion and Conclusions The incidence of axillary nerve palsy after arthroscopic soft-tissue shoulder stabilization was low but higher in shoulders subjected to capsular or HAGL repair. We should always consider the possibility of axillary nerve palsy in shoulders that require capsular or HAGL repair.