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[Recurrent luxations after arthroscopic refixation of the labrum using suture anchors in traumatic ventral shoulder
1Orthopädische Klinik, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg. geza.pap@medizin.uni-magdeburg.de
Objective:
Recurrence rates after arthroscopic labral reconstruction for anterior shoulder instability are still higher than after open procedures. Therefore, proper selection of patients becomes increasingly important. The aim of this study was to investigate factors influencing recurrence rates after arthroscopic labral repair with suture anchors.
Patients And Methods:
We examined 53 patients (43 male, 10 female) with traumatic anterior shoulder dislocations, who were treated with arthroscopic labral repair using Fastak-Suture anchors between 1995 and 1996. The average follow-up time was 18 (12-30) months. The mean age of the patients at the time of operation was 27 (15-44) years.
Results:
Postoperatively, 11 patients (20.7%) reported on redislocations. Recurrence rates increased significantly in patients with more than 4 preoperative dislocations and in patients with bony Bankart lesions. In patients without redislocations, the mean Rowe score improved from 65.9 (SD +/- 12.3) preoperatively to 88.6 (SD +/- 12.5) at follow-up. Thus, there were 24 excellent, 9 good and 6 fair results, while in 3 patients with persisting signs of shoulder instability results had to be estimated as poor. Deficits in the range of motion of more than 15 degrees were seen in 7 patients with predominant affection of the external rotation.
Conclusion:
Frequent preoperative dislocations and bony Bankart lesions contribute substantially to high recurrence rates after arthroscopic labral repair. Therefore, in these cases open procedures should be preferred.