Clinical Outcomes After Arthroscopic 270° Labral Repair in Active-Duty Military Patients: At Minimum 10-Year Follow-up.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2025-06-17 eCollection Date: 2025-06-01 DOI:10.1177/23259671251342592
John K McNamara, Alexis B Sandler, John P Scanaliato, John R Tyler, Ali Boolani, Nata Parnes
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引用次数: 0

Abstract

Background: Active-duty military servicemembers (ADSMs) exhibit a high prevalence of combined-type shoulder instability. Arthroscopic 270° labral repair has demonstrated promising outcomes at short- and intermediate-term follow-up, but there is a paucity of long-term outcomes data among ADSMs.

Purpose: To report the outcomes of arthroscopic 270° labral repair at a minimum of 10-year follow-up in ADSMs.

Study design: Case series; Level of evidence: 4.

Methods: A total of 44 ADSMs who underwent arthroscopic 270° labral repair between January 2010 and December 2012 without major concomitant procedures had ≥10 years of follow-up and were deemed eligible for inclusion. Of these, 38 were included in the final outcome analysis.

Results: Mean follow-up was 140.4 ± 14.4 months. Postoperatively, there was a statistically significant improvement in pain visual analog scale (VAS) scores (8.3 ± 1.3 to 1.63 ± 2.29; P < .0001) as well as American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment (42.7 ± 12.3 to 87.3 ± 19.0; P < .0001), Single Assessment Numeric Evaluation (SANE) (49.5 ± 18.9 to 91.9 ± 11.3; P < .0001), and Rowe instability (45.3 ± 12.5 to 89.3 ± 19.2; P < .0001) scores. There were no significant differences observed between pre- and postoperative range of motion. At final follow-up, 95% of patients met the minimal clinically important difference threshold for VAS, 89% for ASES, 92% for SANE, and 92% for the Rowe score; 58% met the substantial clinical benefit threshold for VAS, 61% for ASES, 11% for SANE, and 74% for Rowe scores; and 74% met the Patient Acceptable Symptom State threshold for VAS, 76% for ASES, 76% for SANE, and 74% for Rowe scores. At final follow-up, 89.5% of patients (n = 34) either returned to unrestricted duty or left the military for reasons other than continued shoulder-related disability, while 86.8% (n = 33) returned to unrestricted physical training. Two patients (5.3%) underwent reoperation, one requiring revision anterior labral repair and the other Latarjet after a traumatic dislocation of the operative shoulder.

Conclusion: Arthroscopic 270° labral repair demonstrates favorable clinical outcomes at a minimum 10-year postoperative follow-up in an active-duty military patient population, with clinically and statistically significant improvements in pain, patient-reported outcomes measures, and an overall return-to-duty rate of 89.5%.

现役军人关节镜下270°唇侧修复术后的临床结果:至少10年随访。
背景:现役军人(ADSMs)表现出高患病率的混合型肩关节不稳定。关节镜下270°唇侧修复术在短期和中期随访中显示出良好的结果,但在ADSMs中缺乏长期结果数据。目的:报告关节镜下270°唇侧修复术对adsm患者至少10年随访的结果。研究设计:病例系列;证据等级:4。方法:在2010年1月至2012年12月期间,共有44例ADSMs接受了关节镜270°唇部修复术,无主要伴随手术,随访≥10年,符合纳入条件。其中38例纳入最终结果分析。结果:平均随访140.4±14.4个月。术后疼痛视觉模拟量表(VAS)评分(8.3±1.3 ~ 1.63±2.29)差异有统计学意义;P < 0.0001),以及美国肩关节外科医生(ASES)标准化肩关节评估(42.7±12.3至87.3±19.0;P < 0.0001),单次评估数值评估(SANE)(49.5±18.9 ~ 91.9±11.3;P < 0.0001), Rowe不稳定性(45.3±12.5 ~ 89.3±19.2;P < 0.0001)评分。术前和术后活动范围无明显差异。在最终随访时,95%的患者达到了VAS最低临床重要差异阈值,89%的患者达到了ASES, 92%的患者达到了SANE, 92%的患者达到了Rowe评分;58%的患者达到了VAS的实际临床获益阈值,61%的患者达到了ASES, 11%的患者达到了SANE, 74%的患者达到了Rowe评分;74%的患者符合VAS可接受症状状态阈值,76%的患者符合asas, 76%的患者符合SANE, 74%的患者符合Rowe评分。在最后的随访中,89.5%的患者(n = 34)要么回到无限制的工作岗位,要么因为肩部相关残疾以外的原因离开军队,而86.8%的患者(n = 33)回到无限制的体育训练。2例患者(5.3%)接受了再手术,其中1例需要前唇翻修修复,另1例在外伤性肩关节脱位后需要Latarjet。结论:关节镜270°唇部修复术在至少10年的术后随访中显示了良好的临床结果,在临床上和统计学上都有显著的疼痛改善,患者报告的结果测量,总体复归率为89.5%。
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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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