2023 ISAKOS Biennial Congress ePoster
Survivorship Following Glenoid Microfracture In Active-Duty Military Patients: 5-Year Follow-Up
John P Scanaliato, MD, El Paso, Texas UNITED STATES
Alexis Sandler, MD, El Paso, Texas UNITED STATES
Clare Green, BS, Washington, DC UNITED STATES
Michael D Baird, MD, Bethesda, MD UNITED STATES
Kelly Fitzpatrick, DO, El Paso, TX UNITED STATES
Jason Uhlinger II, PAC, Carthage, NY UNITED STATES
John Dunn, MD, El Paso, Texas UNITED STATES
Nata Zwi Parnes, MD, Carthage, New York UNITED STATES
Carthage Area Hospital, Carthage, NY, UNITED STATES
FDA Status Not Applicable
Summary
Glenoid microfracture can result in pain relief and symptomatic improvement for a select group of active-duty military patients, with 75% survivorship at five years.
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Abstract
Background
There exists a paucity of survivorship and outcomes data following microfracture for full-thickness glenoid chondral lesions in active-duty military patients.
Purpose
The purpose of this study is to present mid-term patient reported outcomes and survivorship data of active-duty military patients undergoing microfracture for full-thickness cartilage defects of the glenoid.
Methods
All consecutive patients from January 2013 through December 2016 who underwent glenoid microfracture for full-thickness cartilage injuries with complete outcome scores were identified. Twenty patients met final inclusion criteria for the study, and all-were active-duty military at time of surgery. A separate subgroup analysis was performed to determine if dominant-shoulder involvement portends worse outcomes.
Results
In total, 20 patients with grade IV glenoid lesions underwent glenoid microfracture with a mean follow-up of 81.5 ± 19.4 (range 60-108).
Of the 20 patients, 5 required a secondary surgical procedure within 5 years of their index procedure, with an average time to failure of 45.6±13.15 months. Survivorship was 100% at one-year, 85% at three-years, and 75% at five-years post-operative follow up. Average time to treatment failure was 45.6±13.15 months. All five (25%) patients who failed went on to undergo additional surgery: four underwent comprehensive arthroscopic management (CAM) and one underwent an anatomic total shoulder arthroplasty.
For the 15 patients who did not fail, there was a statistically significant increase in the mean American Shoulder and Elbow Surgeons (ASES) score (57.20 vs. 88.27) and Single Assessment Numeric Evaluation (SANE) (45.00 vs. 86.33). Mean pain decreased significantly as measured by the pain VAS (5.40 vs. 1.37). Range of motion in forward elevation, external rotation and internal rotation did not change significantly postoperatively (p = 0.4528, 0.4810 and 0.1919, respectively). A majority of patients (13/20, 65%) were able to remain on unrestricted military active-duty service, but seven (35%) underwent medical discharge, including the five patients who had experienced treatment failure, plus two additional patients with persistent activity-limiting pain inconsistent with continued active-duty service.
Conclusion
Glenoid microfracture can result in pain relief and symptomatic improvement for a select group of active-duty military patients, with 75% survivorship at five years. Approximately one in three (35%) patients, however, were unable to remain on active-duty military service.