Summary

This is the first long-term follow-up study analyzing the minimum 10-year results after arthroscopic capsulolabral repair of posterior labral tears.

Abstract

Background

Posterior shoulder instability (PSI) is a multifactorial condition of atraumatic or traumatic onset and most frequently affects young male athletes. To address capsulolabral detachment, arthroscopic posterior capsulolabral repair with suture anchors can be performed. A relative paucity of long-term clinical outcomes exists despite encouraging short to midterm results.

Purpose

The purpose of this study is to illustrate patient-reported outcomes (PROs), failure rates, and survivorship after arthroscopic posterior capsulolabral repair with suture anchors at a minimum of 10 years after surgery.
Study Design: Retrospective cohort study; Level of evidence, 4.

Methods

Patients who underwent arthroscopic posterior capsulolabral repair for PSI between 11/2005 and 09/2010 were included. Patients with multidirectional instability and concomitant bony reconstruction were excluded. Demographic, surgical, and subjective data were collected prospectively and retrospectively reviewed. PROs collected included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Short Form physical component summary (SF-12 PCS). Recurrent instability, dislocations, and reoperations were recorded, and a survivorship analysis was performed.

Results

Seventeen shoulders (16 patients, all male) with a mean age of 31.4 years old (range, 19.2-51.2) were eligible for inclusion. The onset of PSI was atraumatic in 11 shoulders (65%) and traumatic in 6 shoulders (35%). Three patient shoulders (17.6%) underwent revision surgery for instability or osteoarthritis at 6.3, 7.6, and 12.5 years post-surgery. Minimum 10-year follow-up was obtained in 12 of 14 remaining patients (86%) with a mean follow-up of 13.1 years. Pre- to postoperatively, the ASES score significantly improved (72.6 to 89.9, p=.016), as did SF-12 PCS (43.8 to 55.0, p=0.002). The mean postoperative SANE score was 86.9, and mean postoperative QuickDASH was 6.6. Median satisfaction was 8 (range, 3-10). At follow-up, 67% of patients had returned to their original fitness program. Kaplan-Meier survivorship analysis showed an 86.7% survival rate at 10 years.

Conclusion

Arthroscopic posterior capsulolabral repair is an effective treatment for patients with PSI, with low revision rates and satisfactory PROs that are maintained at long-term follow-up.