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Arthroscopic Circumferential Labral Repair for Patients With Multidirectional Instability: A Comparative Outcome

Andrew Wall1, Owen McGonigle2, Thomas J Gill3

  • 1University of Albany Medical School, Albany, New York, USA.

Orthopaedic Journal of Sports Medicine
|January 8, 2020
PubMed
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Arthroscopic 360° circumferential labral repair shows similar outcomes to anterior labral repair for shoulder instability. Patient selection is key for successful outcomes in these complex shoulder instability cases.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Arthroscopy

Background:

  • Circumferential glenohumeral labrum tears are rare, accounting for 2.4% of labral injuries.
  • Clinical outcomes of arthroscopic circumferential labral repair for combined anterior, posterior, and superior tears with instability are not well-documented.

Purpose of the Study:

  • To compare clinical outcomes and failure rates of arthroscopic circumferential labral repair versus isolated arthroscopic anterior labral repair for shoulder instability.
  • To evaluate patient satisfaction, pain, and instability following these procedures.

Main Methods:

  • Retrospective cohort study (Level of evidence, 3) comparing 35 patients with circumferential repairs to 31 age-matched controls with anterior repairs.
  • Assessment of American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST), SF-12 (mental and physical), and patient satisfaction.
Keywords:
instabilitymultidirectionaloutcomesrepairshoulder

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  • Follow-up averaged 34.3 months for circumferential and 56.8 months for anterior repairs.

    • Main Results:

    • No significant differences in overall satisfaction or recurrent instability between the groups.
    • Pain reported by 22% (circumferential) vs. 15% (anterior); instability by 25% (circumferential) vs. 30% (anterior).
    • Similar ASES, SST, SF-12 mental/physical scores, and range of motion between groups post-surgery.

    Conclusions:

    • Arthroscopic 360° circumferential labral repair yields comparable shoulder stability and function to isolated anterior labral repair.
    • Proper patient selection is crucial for achieving similar successful outcomes with the more extensive circumferential procedure.