Current literature reports high satisfactory short- and mid-term clinical outcomes in patients with arthroscopic 270° labral tear repairs. However, data on long term clinical and functional outcomes as well as complication rates in patients with traumatic shoulder instability involving anterior, inferior, and posterior labral injury remains limited.
To investigate the clinical and functional outcomes as well as complications and re-instability in patients with 270° labral tears involving anterior, inferior, and posterior labral injury treated with arthroscopic stabilization using suture anchors at a minimum 10-year follow-up.
Study Design: Case series; Level of evidence, 4.
A retrospective study of prospectively collected outcomes data for all patients undergoing arthroscopic 270° labral tear repairs with suture anchors by a single surgeon at a minimum 10-year follow-up were analyzed. Outcome measures included preoperative and postoperative Rowe, American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), Visual Analog Scale (VAS) Pain, and Single Assessment Numeric Evaluation (SANE) scores. Western Ontario Shoulder Instability Index (WOSI) scores were collected post-operatively. Complications including continued instability, subluxation or dislocation events, and revision surgeries were collected. Failure was defined as any cause of revision surgery.
Thirty-five 270° labral repairs were performed in 34 patients by a single surgeon. Twenty-one patients (62%) were followed at a mean time from surgery of 11.8 years. Outcome measures showered statistically significant improvements at 10 years compared to preoperative scores with Rowe (54 to 89; P = 0.005), ASES (73 to 92; P = 0.004), SST (9 to 11; P = 0.013), pain (2.5 to 0.5; P = 0.037), and SANE (24 to 92; P = 0.043). The mean postoperative WOSI score at 10 years was 256. Overall, WOSI scores remained the same or improved from 2 to 10 years postoperatively. Three patients had postoperative complications including a traumatic subluxation, continued instability, and a traumatic dislocation; two of which required revision surgery (9.5% failure rate).
Arthroscopic repairs of 270° labral tears involving the anterior, inferior and posterior labrum have high satisfactory clinical outcomes at 10 years, with complication and relocation rates similar to those at 2 years.
Key Terms: 270° labrum, labral repair, outcomes, shoulder, instability; dislocation
What is known about the subject: Clinical outcomes at short- and mid-term follow-up after arthroscopic repair of 270° labral tears are excellent with high rates of return-to-sport. However, high complication rates have been reported in up to 30% of cases.
What this study adds to existing knowledge: The data from this study shows excellent long-term outcomes following arthroscopic repair of 270° labral repairs, with few cases of recurrent instability or revision surgery. As a result, the presented data suggests that repairs of extensile labral tears are effective in restoring and maintaining mechanical stability of the glenohumeral joint long-term, thus avoiding future interventions addressing re-instability.