Revision Arthroscopic Posterior Shoulder Capsulolabral Repair in Contact Athletes: Risk Factors and Outcomes

被引:26
作者
Bradley, James P. [1 ]
Arner, Justin W. [2 ]
Jayakumar, Sachidhanand [3 ]
Vyas, Dharmesh [4 ]
机构
[1] Univ Pittsburgh, Med Ctr, Burke & Bradley Orthoped, Pittsburgh, PA 15215 USA
[2] Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Pittsburgh, PA 15215 USA
[3] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15215 USA
[4] Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Cranberry, PA USA
关键词
INSTABILITY; RECONSTRUCTION; SUBLUXATION;
D O I
10.1016/j.arthro.2019.09.029
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To determine risk factors and outcomes of revision arthroscopic posterior capsulolabral repair in contact athletes. Methods: Contact athletes with unidirectional posterior instability who underwent arthroscopic posterior capsulolabral repair from 2000 to 2014 with minimum 4-year follow-up were reviewed. Revision rate was determined and those who required revision surgery were compared with those who did not. Age, gender, labral and/or capsular injury, level of sport, and return to sport were compared. Pre- and postoperative American Shoulder and Elbow Surgeons, pain, function, stability, range of motion, strength, and satisfaction were also compared. Magnetic resonance imaging measurements of glenoid bone width, glenoid version, labral width, labral version, and cartilage version were also compared. Results: A total of 149 contact athletes' shoulders met inclusion criteria. Eight shoulders required revision surgery (5.4%) at 13.0-year follow-up with 2.6 years between primary surgery and revision. Preoperative stability was significantly worse in those that required revision (0.008). Postoperative American Shoulder and Elbow Surgeons score was significantly worse in the revision group (75.1 vs 87.8, P = .03). The only significant risk factor for requiring revision surgery was decreased glenoid bone width (26.4 mm vs 29.1 mm, P = .005). Cartilage version, labral version, and bone version were not significantly different, nor was labral width. Sex, labral injury, capsule injury, both capsule and labrum injury, and level of sport were not risk factors. Both return to sport at the same level (revision = 16.7% vs nonrevision = 72.1%, P < .001) and overall return to sport (revision = 50.0% vs nonrevision=93.7%, P < .001) were significantly worse in the revision group. Conclusions: Contact athletes underwent revision arthroscopic posterior capsulolabral repair at an incidence of 5.4% at minimum 4-year and average 13.0-year follow-up. The only significant risk factors for requiring revision surgery was smaller glenoid bone width and higher preoperative instability. Return to play after their subsequent surgery was significantly worse.
引用
收藏
页码:660 / 665
页数:6
相关论文
共 21 条
[1]   Arthroscopic Stabilization of Posterior Shoulder Instability Is Successful in American Football Players [J].
Arner, Justin W. ;
McClincy, Michael P. ;
Bradley, James P. .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2015, 31 (08) :1466-1471
[2]   A Prospective Analysis of Patients With Anterior Versus Posterior Shoulder Instability: A Matched Cohort Examination and Surgical Outcome Analysis of 200 Patients [J].
Bernhardson, Andrew S. ;
Murphy, Colin P. ;
Aman, Zachary S. ;
LaPrade, Robert F. ;
Provencher, Matthew T. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2019, 47 (03) :682-687
[3]   Risk Factors and Outcomes of Revision Arthroscopic Posterior Shoulder Capsulolabral Repair [J].
Bradley, James P. ;
Arner, Justin W. ;
Jayakumar, Sachidhanand ;
Vyas, Dharmesh .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2018, 46 (10) :2457-2465
[4]   Arthroscopic Capsulolabral Reconstruction for Posterior Instability of the Shoulder A Prospective Study of 200 Shoulders [J].
Bradley, James P. ;
McClincy, Michael P. ;
Arner, Justin W. ;
Tejwani, Samir G. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2013, 41 (09) :2005-2014
[5]   Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder - A prospective study of 100 shoulders [J].
Bradley, JR ;
Baker, CL ;
Kline, AJ ;
Armfield, DR ;
Chhabra, A .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2006, 34 (07) :1061-1071
[6]   Posterior Shoulder Instability in Overhead Athletes [J].
Chang, Edward S. ;
Greco, Nicholas J. ;
McClincy, Michael P. ;
Bradley, James P. .
ORTHOPEDIC CLINICS OF NORTH AMERICA, 2016, 47 (01) :179-+
[7]   Posterior Instability of the Shoulder: A Systematic Review and Meta-analysis of Clinical Outcomes [J].
DeLong, Jeffrey M. ;
Jiang, Kevin ;
Bradley, James P. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2015, 43 (07) :1805-1817
[8]   Posterior Glenohumeral Instability: Evidence-based Treatment [J].
Frank, Rachel M. ;
Romeo, Anthony A. ;
Provencher, Matthew T. .
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2017, 25 (09) :610-623
[9]   POSTERIOR SUBLUXATION OF THE GLENOHUMERAL JOINT [J].
FRONEK, J ;
WARREN, RF ;
BOWEN, M .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1989, 71A (02) :205-216
[10]  
Harris JD, 2017, ARTHROSCOPY, V33, P1102, DOI 10.1016/j.arthro.2017.01.053