Arthroscopic repair for chronic anterior shoulder instability: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions

Abstract

Background: Although labrum lesions in patients with chronic anterior shoulder instability may not only involve detachment of the anteroinferior labrum but a lesion of the superior glenoid labrum as well, no studies have compared the clinical outcome between patients with a lesion of the anteroinferior labrum and patients with a combined lesion of the anterior and superior labrum after arthroscopic shoulder stabilization.

Hypothesis: Arthroscopic repair of a combined lesion of the anterior and superior labrum may have inferior clinical outcome to repair of an anterior lesion only in patients with anterior shoulder instability.

Study design: Cohort study; Level of evidence, 2.

Methods: Sixty-three patients operated on for anterior shoulder instability between April 2002 and June 2006 were included in this study. Patients with bone deficiency were excluded. Fixation of the detached labrum was performed using suture anchors. Thirty-eight patients had a lesion of the anterior labrum (group A), and 25 had a combined lesion of the anterior and superior labrum (group B). Patients were evaluated after a 2-year minimum follow-up with Constant and Rowe scores. Failure was defined as a redislocation or a subluxation episode.

Results: Patients in group B experienced a significantly higher number of dislocations preoperatively (P < .05). However, there was no difference between the 2 groups regarding the failure rate postoperatively. One patient from each group had a failed result. A mean loss of 5 degrees and 8 degrees of external rotation at 90 degrees of abduction was noted in patients in groups A and B, respectively (P = .113). The Constant score was 94 in group A and 93 in group B (P = .435). The Rowe score was 91 in group A and 90 in group B (P = .338).

Conclusion: There are no differences in shoulder stability and function in patients with anterior shoulder instability and a lesion of the anteroinferior labrum and patients with an extended lesion of the anterior and superior labrum after arthroscopic shoulder stabilization.