Long-Term Functional, Sports- and Work-Related Outcomes After Arthroscopic Capsulolabral Revision Repair for...

Although short- to mid-term clinical data of patients undergoing arthroscopic capsulolabral revision repair (ACRR) for recurrent anterior shoulder instability are promising, evidence pertaining to long-term functional, sports- and work-related outcomes is scarce.

The purpose was to provide prospectively collected long-term functional outcomes, sports activity, and work ability of patients undergoing ACRR for recurrent anterior shoulder instability. It was hypothesized that patients would maintain significant functional improvement, along with sufficient sports activity and work ability, at a minimum follow-up of 20 years.

Case Series; Level of Evidence 4.

Patients who underwent ACRR between September 1998 and August 2003 and had a minimum follow-up of 20 years were analyzed. Functional outcome measures included the Rowe and Constant-Murley (CM) scores, as well as the visual analog scale (VAS) for pain, which were collected preoperatively, at short-term follow-up (a minimum of 2 years), and at a minimum final follow-up of 20 years. The Single Assessment Numeric Evaluation and Simple Shoulder Test (SST) scores were only collected at the final follow-up. Return to sports and work-including sports and work level and discipline-were evaluated using a custom sports and work ability assessment tool.

A total of 29 patients (mean age at surgery, 28.6 ± 9.8 years) were included in the study, with a mean follow-up of 21.1 ± 1.5 years (range, 20-24 years). The rate of recurrent instability was 27.6% (n = 8), while 10.3% (n = 3) underwent revision surgery. In those without recurrent instability, the Rowe and CM scores showed significant improvements at both the minimum 2-year and minimum 20-year follow-ups, compared with preoperatively (P < .001, respectively). Neither the CM (87.9 ± 8 vs 83.4 ± 11; P = .055) nor the Rowe (86.7 ± 18.7 vs 86.9 ± 15.8; P = .958) score differed significantly between the minimum 2-year and 20-year follow-ups. At the minimum 20-year follow-up, the VAS pain score was 0.6 ± 1.6 at rest, was 1.1 ± 1.4 during exercise, and the SST (%) was 89.3 ± 13.5. The amount of activity (P = .022) and the subjective shoulder mobility (P = .021) significantly declined from the minimum 2-year to the 20-year follow-up.

Patients undergoing ACRR for recurrent anterior shoulder instability had a recurrent instability rate of 27.6% at a minimum 20-year follow-up. Those patients without recurrence maintained significant improvements in functional outcomes and achieved a favorable postoperative sport activity and work ability.