Simo S A Miettinen1, Tatu Kiljunen2, Antti Joukainen2. 1. Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland; Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland. Electronic address: simo.miettinen@kuh.fi. 2. Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland.
Abstract
BACKGROUND: This retrospective study investigated 5-year results of primary arthroscopic operation for anterior glenohumeral instability (AI) with special interest in patients aged <25 years and gender. HYPOTHESIS: Recurrence of AI is higher in male patients aged <25 years than older patients or females. PATIENTS AND METHODS: Primary arthroscopic Bankart repair was performed between January 2009 and December 2015 on 156 shoulders [154 patients, 104/156 (67%) males]. The mean follow-up was 5.6 (SD 2.1, range 0.4-8.9) years. Outcome measures, including re-dislocation, fear of dislocation, Western Ontario Instability Index, Subjective Shoulder Value and pain Numerical Rating Scale scores, the number of revision surgeries and satisfaction with the result of surgical treatment, were assessed for 130 shoulders [82/130 (63%) males]. AI recurrence was defined as a dislocation or a fear of such. RESULTS: The Kaplan-Meier analysis estimates for the cumulative survival of stable shoulders were 28% at 8.8 years for patients aged <25 years (SE 0.4, CI 95% 5.5-7.2) and 53% at 8.9 years for patients aged ≥25 years (SE 0.2, CI 95% 7.2-8.0; p = 0.005). The Kaplan-Meier estimates for the cumulative survival of stable shoulders were 50% at 8.9 years for males (SE 0.3, CI 95% 6.8-7.8) and 37% at 8.6 years for females (SE 0.3, CI 95% 6.5-7.7; p = 0.8). Mean time to revision was 2.4 (SD 1.7, range 0.4-5.3) years. DISCUSSION: Recurrence of AI was higher in the patients aged <25 years (p = 0.005) but gender was not a risk factor. Re-operation rate due to recurrent AI was 10% in this 5-year follow-up. LEVEL OF EVIDENCE: III; Case-control study.
BACKGROUND: This retrospective study investigated 5-year results of primary arthroscopic operation for anterior glenohumeral instability (AI) with special interest in patients aged <25 years and gender. HYPOTHESIS: Recurrence of AI is higher in male patients aged <25 years than older patients or females. PATIENTS AND METHODS: Primary arthroscopic Bankart repair was performed between January 2009 and December 2015 on 156 shoulders [154 patients, 104/156 (67%) males]. The mean follow-up was 5.6 (SD 2.1, range 0.4-8.9) years. Outcome measures, including re-dislocation, fear of dislocation, Western Ontario Instability Index, Subjective Shoulder Value and pain Numerical Rating Scale scores, the number of revision surgeries and satisfaction with the result of surgical treatment, were assessed for 130 shoulders [82/130 (63%) males]. AI recurrence was defined as a dislocation or a fear of such. RESULTS: The Kaplan-Meier analysis estimates for the cumulative survival of stable shoulders were 28% at 8.8 years for patients aged <25 years (SE 0.4, CI 95% 5.5-7.2) and 53% at 8.9 years for patients aged ≥25 years (SE 0.2, CI 95% 7.2-8.0; p = 0.005). The Kaplan-Meier estimates for the cumulative survival of stable shoulders were 50% at 8.9 years for males (SE 0.3, CI 95% 6.8-7.8) and 37% at 8.6 years for females (SE 0.3, CI 95% 6.5-7.7; p = 0.8). Mean time to revision was 2.4 (SD 1.7, range 0.4-5.3) years. DISCUSSION: Recurrence of AI was higher in the patients aged <25 years (p = 0.005) but gender was not a risk factor. Re-operation rate due to recurrent AI was 10% in this 5-year follow-up. LEVEL OF EVIDENCE: III; Case-control study.