Glenoid labral articular disruption lesions in the setting of first-time anterior shoulder instability.

Abstract

Purpose: The purpose of this study was to compare the clinical outcomes and rates of recurrent instability of patients following arthroscopic Bankart repair with and without GLAD lesions in the setting of first-time anterior instability events.

Methods: This was a retrospective comparative case series of consecutive patients with GLAD lesions in the setting of first-time anterior instability events who underwent arthroscopic Bankart repair. Patients with GLAD lesions (cases) were matched in a 1:3 ratio for sex, age, BMI, and sport to those without GLAD lesions (controls). Primary outcomes included postoperative ROM (forward elevation and external rotation) and PROs: Subjective Shoulder Value (SSV), Visual Analog Scale (VAS), and Western Ontario Shoulder Instability Index (WOSI). Recurrent instability following primary arthroscopic stabilization was also collected. STATA was used for data analysis. Statistical significance was set at P ≤ 0.05.

Results: A total of 56 patients undergoing arthroscopic anterior stabilization between 2012-2020 were included for analysis, of which 14 patients had GLAD lesions while the remaining 42 were controls. Average follow-up time from surgery in controls was 8.2 years (3.1 - 11.7) while the average follow-up in GLAD patients was 7.6 years (3.8 - 11.8). There were no differences in postoperative forward flexion or external rotation, and no difference in SSV, VAS, or WOSI scores. The rate of recurrent instability was found to be the same in both the control and GLAD groups (7% vs. 7% respectively, p=0.16).

Conclusion: Patients with GLAD lesions in the setting of first-time anterior instability had comparable PROs, forward flexion, and external rotation postoperatively to controls. In addition, the presence of a GLAD lesion did not influence the rate of recurrent instability.

Level of evidence: Level IV Retrospective Comparative Case Series.