Instability Severity Index Score – ISIS

As discussed at the recent Brisbane Knee and Sports Surgery Physiotherapy Education evening, below is the instability severity index score (ISIS score) that Dr Macgroarty uses to help determine the best treatment for his athletes with antero-inferior shoulder instability after sport injuries.

 

Prognostic Factors                            Points

age at surgery

</= 20                                                        2

> 20                                                           0

degree of sports participation

competitive                                                2

recreational                                               0

type of sport

contact or forced overhead                       2

other                                                          0

shoulder hyper-laxity

antero-inferior                                          1

normal                                                      0

Hill Sachs Lesion on AP radiograph

visible on ER view                                    2

not visible on ER                                      0

glenoid loss of contour on AP radiograph

loss of contour                                          2

no lesion                                                   0

Total                                                        10

 

</= 6  – acceptable recurrence rate of </= 10% with arthroscopic reconstruction

 

> 6     –  recurrence risk of 70% with arthroscopic reconstruction

–  recommend open surgery (e.g.. Laterjet procedure)

 

Reference

J Bone Joint Surg Br.    2007 Nov; 89(11) : 1470-7

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