Anterior shoulder reconstruction: prognostic variables

To evaluate factors that have prognostic relevance to the outcome of anterior shoulder stabilization procedures, a retrospective review of 282 serial anterior repairs was carried out. All patients were contacted by questionnaire to provide updated outcome information. Twenty-nine patients were lost to follow-up, leaving 253 shoulders in the series. Surgical outcome was based on the Rowe scores derived from the responses to the follow-up survey. At a mean follow-up of 8.7 years, 5 factors were found to have a negative influence on the result of surgery, on the basis of multivariate analysis. These were the presence of a workers' compensation issue, a voluntary instability pattern, a prior instability surgery, shorter periods of postoperative immobilization, and the age of the patient. Factors that were found to have no statistically significant relationship to the result were the sex of the patient, the presence of a Hill-Sachs lesion, the type of instability, the presence of a labral tear, and the experience of the surgeon. Knowledge of these factors can help guide surgical decision making.