In Park1, Chan-Jae Park2, Jae-Hoo Lee1, Hwan-Sub Hyun1, Jin-Young Park3, Sang-Jin Shin4. 1. Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Seoul, Republic of Korea. 2. Department of Orthopedic Surgery, Bumin Haeundae Hospital, Busan, Republic of Korea. 3. Center for Shoulder, Elbow and Sports Medicine, Neon Orthopaedic Clinic, Seoul, Republic of Korea. 4. Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Seoul, Republic of Korea. Electronic address: sjshin622@ewha.ac.kr.
Abstract
PURPOSE: To evaluate the clinical outcomes and recurrence rates of arthroscopic stabilization procedures in young patients who had recurrent anterior shoulder instability with a glenoid bone erosion more than 20%, and to compare with those in patients with a glenoid bone erosion less than 20%. METHODS: A total of 161 patients who underwent an arthroscopic stabilization procedure for recurrent anterior shoulder instability with anterior glenoid bone erosions and at least 2 years of follow-up were included. Patients were divided into 2 groups based on the glenoid defect size (group I [32 patients]: erosion >20%, group II [129 patients]: erosion <20%). The clinical outcomes were compared using the American Shoulder Elbow Surgeons (ASES) score, Rowe score, and sports/recreation activity level between the 2 groups. Postoperative complications including instability recurrence were documented. RESULTS: The mean glenoid defect size was 22.1 ± 2.1% in group I, and 12.2 ± 3.7% in group II. In group I, clinical outcomes were significantly improved after operation (ASES score: 57.9 ± 14.3 at initial, 88.9 ± 6.2 at the last visit, P = .001; Rowe score: 42.1 ± 15.6 at initial, 87.4 ± 7.6 at the last visit, P = .001). These results were inferior to the clinical outcomes of patients in group II (ASES score: 91.5 ± 12.7, P < .001; Rowe score: 89.3 ± 12.4, P = .01). Postoperative recurrences occurred in 5 patients (15.6%) in group I, whereas patients in group II showed 5.4% of recurrence rate (P = .05). Competent recoveries to sports/recreation activity were achieved in 84.4% of patients in group I. CONCLUSIONS: Arthroscopic stabilization procedures for recurrent anterior shoulder instability in young patients with glenoid bone erosions more than 20% showed satisfactory clinical outcomes and recurrence rate, although these results were inferior to those of patients with glenoid erosions less than 20%. Arthroscopic stabilization procedures can be applied as the primary treatment of recurrent anterior shoulder instability with a large glenoid bone erosion for functional restoration and return to previous sports activity level. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
PURPOSE: To evaluate the clinical outcomes and recurrence rates of arthroscopic stabilization procedures in young patients who had recurrent anterior shoulder instability with a glenoid bone erosion more than 20%, and to compare with those in patients with a glenoid bone erosion less than 20%. METHODS: A total of 161 patients who underwent an arthroscopic stabilization procedure for recurrent anterior shoulder instability with anterior glenoid bone erosions and at least 2 years of follow-up were included. Patients were divided into 2 groups based on the glenoid defect size (group I [32 patients]: erosion >20%, group II [129 patients]: erosion <20%). The clinical outcomes were compared using the American Shoulder Elbow Surgeons (ASES) score, Rowe score, and sports/recreation activity level between the 2 groups. Postoperative complications including instability recurrence were documented. RESULTS: The mean glenoid defect size was 22.1 ± 2.1% in group I, and 12.2 ± 3.7% in group II. In group I, clinical outcomes were significantly improved after operation (ASES score: 57.9 ± 14.3 at initial, 88.9 ± 6.2 at the last visit, P = .001; Rowe score: 42.1 ± 15.6 at initial, 87.4 ± 7.6 at the last visit, P = .001). These results were inferior to the clinical outcomes of patients in group II (ASES score: 91.5 ± 12.7, P < .001; Rowe score: 89.3 ± 12.4, P = .01). Postoperative recurrences occurred in 5 patients (15.6%) in group I, whereas patients in group II showed 5.4% of recurrence rate (P = .05). Competent recoveries to sports/recreation activity were achieved in 84.4% of patients in group I. CONCLUSIONS: Arthroscopic stabilization procedures for recurrent anterior shoulder instability in young patients with glenoid bone erosions more than 20% showed satisfactory clinical outcomes and recurrence rate, although these results were inferior to those of patients with glenoid erosions less than 20%. Arthroscopic stabilization procedures can be applied as the primary treatment of recurrent anterior shoulder instability with a large glenoid bone erosion for functional restoration and return to previous sports activity level. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Authors: Hassanin Alkaduhimi; James W Connelly; Derek F P van Deurzen; Denise Eygendaal; Michel P J van den Bekerom Journal: Arthrosc Sports Med Rehabil Date: 2021-04-06