Mid- to Long-Term Clinical Outcomes and Failure Rates After ALPSA Lesion Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions are linked to recurrent shoulder instability.
• These lesions may have higher failure rates after capsulolabral repair than Bankart lesions.
• Limited data exist on associated conditions and outcomes for ALPSA lesions in young, active individuals.

Purpose of the Study:

• To evaluate the mid- to long-term clinical course and failure rates of ALPSA repairs.
• To identify factors associated with outcomes after ALPSA repair.

Main Methods:

• Retrospective cohort study of patients undergoing arthroscopic labral repair.
• Comparison of patients with ALPSA lesions versus matched patients with non-ALPSA lesions.
• Analysis of failure, revision surgery, and associated factors using survival analysis and logistic regression.

Main Results:

• ALPSA lesions were associated with more preoperative dislocations and Hill-Sachs lesions (HSLs).
• No significant difference in overall failure or recurrent instability rates between ALPSA and non-ALPSA groups.
• ALPSA repairs showed earlier failure onset compared to non-ALPSA repairs.

Conclusions:

• ALPSA lesions in anterior instability are linked to HSLs and multiple dislocations.
• ALPSA repair failure rates are similar long-term but occur earlier postoperatively compared to Bankart repairs.