Arthroscopic treatment of multidirectional shoulder instability with minimum 270° labral repair:: Minimum 2-year follow-up

Purpose: The purpose of this study was to analyze results of arthroscopic stabilization with labral repair in a subset of patients with multidirectional shoulder instability and frank labral tear. Methods: A review of 13 patients (10 male and 3 female; mean age, 27.2 years) with multidirectional instability involving a labral tear of 270 degrees or greater requiring arthroscopic labral repair was performed at a mean follow-up of 56 months (range, 29 to 72 months). All patients were evaluated by use of the Short Form 12, Western Ontario Shoulder Instability Index, Simple Shoulder Test, American Shoulder and Elbow Surgeons score, and visual analog pain scale. Physical examination included range of motion, strength testing, and stability testing. Results: Of the 13 patients, 2 (15%) had recurrent instability after repair (subluxation or dislocation). Of the patients, 9 (69%) were completely satisfied, 2 (15%) were mostly satisfied, and 2 (15%) were completely unsatisfied. At final follow-up, the median scores were as follows: Western Ontario Shoulder Instability Index, 471; American Shoulder and Elbow Surgeons score, 96.7; Simple Shoulder Test score, 12; visual analog pain scale, 0; and Short Form 12 mental component/physical component, 57/44. There were no differences in range of motion compared with the opposite extremity. Cybex strength testing (Lumex, Ronkonkoma, NY) did show a statistically different difference in forward elevation (P < .005). There were no complications, and no patient has undergone reoperation. Conclusions: Arthroscopic stabilization with labral repair in patients with multidirectional instability and a minimum 270 degrees labral pathology provided good results (85%) in terms of pain relief and clinical stability at a minimum 2-year follow-up. Level of Evidence: Level IV, retrospective case series.