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. 2021 May 20;9(5):23259671211008841.
doi: 10.1177/23259671211008841. eCollection 2021 May.

Sex-Based Differences in Clinical Outcomes After Arthroscopic Anterior Shoulder Stabilization: Results at 5-Year Follow-up

Mo Chen  1 , Sijia Feng  1 , Yuzhou Chen  1 , Zheci Ding  1 , Yuxue Xie  2 , Jiwu Chen  1 , Yinghui Hua  1 , Jun Chen  1 , Jianjun Yang  3 , Shiyi Chen  1
Affiliations

Sex-Based Differences in Clinical Outcomes After Arthroscopic Anterior Shoulder Stabilization: Results at 5-Year Follow-up

Mo Chen et al. Orthop J Sports Med. .

Abstract

Background: The influence of patient sex on clinical outcomes after arthroscopic anterior shoulder stabilization is unclear.

Purpose: To investigate sex-based differences in clinical outcomes after arthroscopic anterior shoulder stabilization.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective study was conducted among 76 patients who underwent arthroscopic anterior shoulder stabilization from February 2010 to December 2017. The patients were grouped by sex. The recurrence rate of instability was compared, as were pre- and postoperative pain scores, functional outcome scores, and active range of motion (ROM). Postoperative magnetic resonance imaging (MRI) was also performed for structural assessment of the glenohumeral joint.

Results: No significant difference was found in the recurrence rate between female and male patients (13.3% vs 14.8%; P ≥ .999; risk ratio, 1.107 [95% CI, 0.266-4.597]). Compared with male patients, female patients had a significantly lower preoperative Constant score (94.4 ± 6.4 vs 85.4 ± 11.1; P = .002), forward flexion (173.8° ± 10.7° vs 154.0° ± 33.8°; P = .011), abduction (171.0° ± 18.4° vs 142.7° ± 39.9°; P = .001), and external rotation (76.6° ± 21.6° vs 67.7° ± 20.4°; P = .037). Postoperatively, female patients had a significantly lower Simple Shoulder Test score compared with men (8.8 ± 1.9 vs 10.3 ± 1.6; P = .005). The mean changes from pre- to postoperative Rowe score (43.6 ± 21.4 vs 31.5 ± 19.8; P = .044), Constant score (9.9 ± 8.9 vs 0.8 ± 8.1; P = .002), forward flexion (24.0 ± 36.2 vs 4.2 ± 10.9; P = .013), abduction (36.0 ± 38.3 vs 7.6 ± 18.4; P < .001), and external rotation (19.7 ± 21.3 vs 6.7 ± 26.2; P = .023) in female patients were significantly higher than those in the men. There were no sex-based differences on any MRI parameter measured.

Conclusion: Female patients had a similar recurrence rate as that of male patients after arthroscopic anterior shoulder stabilization. Most postoperative clinical outcome measures showed no significant difference between the sexes. Despite worse preoperative values, more significant improvements in postoperative shoulder function and active ROM were seen in women.

Keywords: anterior shoulder instability; arthroscopic shoulder stabilization; clinical outcome; recurrence; sex.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Funding for this study was received from the National Key R&D Program of China (2016YFC1100300), the National Natural Science Foundation of China (Nos. 81572108, 81772339, 8181101445, 81811530750, 81811530389, and 81972129), the Key Clinical Medicine Center of Shanghai (2017ZZ01006), the Sanming Project of Medicine in Shenzhen (SZSM201612078), the Shanghai Rising-Star Project (18QB1400500), and the Introduction Project of Clinical Medicine Expert Team for Suzhou (SZYJTD201714), Development Project of Shanghai Peak Disciplines-Integrative Medicine (20180101), and Shanghai Committee of Science and Technology (19441901600 and 19441902000). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Mean pre- to postoperative changes in outcomes between the sexes. *P < .05; **P < .01; n.s., not significant. #Absolute values were used in place of negative numbers.
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