Arthroscopic Repair for Chronic Anterior Shoulder Instability

Abstract

Background Although labrum lesions in patients with chronic anterior shoulder instability may not only involve detachment of the anteroinferior labrum but a lesion of the superior glenoid labrum as well, no studies have compared the clinical outcome between patients with a lesion of the anteroinferior labrum and patients with a combined lesion of the anterior and superior labrum after arthroscopic shoulder stabilization. Hypothesis Arthroscopic repair of a combined lesion of the anterior and superior labrum may have inferior clinical outcome to repair of an anterior lesion only in patients with anterior shoulder instability. Study Design Cohort study; Level of evidence, 2. Methods Sixty-three patients operated on for anterior shoulder instability between April 2002 and June 2006 were included in this study. Patients with bone deficiency were excluded. Fixation of the detached labrum was performed using suture anchors. Thirty-eight patients had a lesion of the anterior labrum (group A), and 25 had a combined lesion of the anterior and superior labrum (group B). Patients were evaluated after a 2-year minimum follow-up with Constant and Rowe scores. Failure was defined as a redislocation or a subluxation episode. Results Patients in group B experienced a significantly higher number of dislocations preoperatively ( P < .05). However, there was no difference between the 2 groups regarding the failure rate postoperatively. One patient from each group had a failed result. A mean loss of 5° and 8° of external rotation at 90° of abduction was noted in patients in groups A and B, respectively ( P = .113). The Constant score was 94 in group A and 93 in group B ( P = .435). The Rowe score was 91 in group A and 90 in group B ( P = .338). Conclusion There are no differences in shoulder stability and function in patients with anterior shoulder instability and a lesion of the anteroinferior labrum and patients with an extended lesion of the anterior and superior labrum after arthroscopic shoulder stabilization.