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

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.
• 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.