Minimum 10-Year Outcomes of Arthroscopic Capsulolabral Repair for Posterior Shoulder Instability.

Abstract

Background: Posterior shoulder instability (PSI) is a multifactorial condition of atraumatic or traumatic onset that most frequently affects young male athletes. To address capsulolabral detachment, arthroscopic posterior capsulolabral repair with suture anchors can be performed.

Purpose: To report patient-reported outcomes (PROs), failure rates, survivorship, and return-to-sport/activity rates after arthroscopic posterior capsulolabral repair with suture anchors at a minimum of 10 years after surgery.

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

Methods: Patients who underwent arthroscopic posterior capsulolabral repair for PSI by a single surgeon between November 2005 and September 2010 were included; patients with multidirectional instability and concomitant bony reconstruction were excluded. Demographic, surgical, and subjective data were collected prospectively and retrospectively reviewed. PROs that were collected included the American Shoulder and Elbow Surgeons (ASES); Single Assessment Numeric Evaluation (SANE); Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH); and 12-Item Short Form physical component summary (SF-12 PCS) scores. Recurrent instability, dislocations, and reoperations were recorded, and a survivorship analysis was performed.

Results: Overall, 17 shoulders in 16 patients (all male; mean age, 31.4 years; age range, 19.2-51.2 years) were included. The onset of PSI was atraumatic in 11 shoulders (65%) and traumatic in 6 shoulders (35%). Three patient shoulders (17.6%) underwent revision surgery for instability or osteoarthritis at 6.3, 7.6, and 12.5 years postoperatively. A minimum 10-year follow-up was obtained in 12 of 14 remaining shoulders (86%), with a mean follow-up of 13.1 years. For patients not requiring revision surgery, pre- to postoperatively, the ASES score significantly improved (72.6 to 89.9; P = .016), as did the SF-12 PCS score (43.8 to 55.0; P = .002). The mean postoperative SANE score was 86.9, and the mean postoperative QuickDASH score was 6.6. Median satisfaction was 8 (range, 3-10). At follow-up, 67% of patients had returned to their original fitness program. Kaplan-Meier survivorship analysis showed an 86.7% survival rate at 10 years.

Conclusion: Study findings indicated that arthroscopic posterior capsulolabral repair was an effective treatment for patients with PSI, albeit with a 17.6% revision rate. Patients who did not require revision had satisfactory PRO scores that were maintained at long-term follow-up.