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Arthroscopic Stabilization for Recurrent Shoulder Instability With Moderate Glenoid Bone Defect in Patients With Moderate to Low Functional Demand

Authors
 Sung-Jae Kim  ;  Sung-Hwan Kim  ;  Byoung-Kyu Park  ;  Yong-Min Chun 
Citation
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol.30(8) : 921-927, 2014 
Journal Title
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
ISSN
 0749-8063 
Issue Date
2014
MeSH
Adolescent ; Adult ; Arthroscopy ; Bone Resorption/diagnostic imaging* ; Female ; Humans ; Imaging, Three-Dimensional ; Joint Instability/physiopathology ; Joint Instability/surgery* ; Male ; Middle Aged ; Recovery of Function ; Recurrence ; Scapula/diagnostic imaging* ; Scapula/pathology ; Shoulder Dislocation/physiopathology ; Shoulder Dislocation/surgery* ; Shoulder Joint/physiopathology ; Shoulder Joint/surgery* ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
Abstract
PURPOSE: The purpose of this study was to investigate the functional outcomes of arthroscopic Bankart repair for recurrent shoulder instability in the setting of moderate glenoid bone defect ranging from 20% to 30% in patients with moderate to low functional demand.
METHODS:This study included 36 patients with unilateral recurrent instability and glenoid bone defects of 20% to 30% treated with arthroscopic stabilization. Glenoid bone loss was estimated on the en-face view of preoperative 3-dimensional computed tomography. Joint laxity was assessed clinically by use of the Beighton and Horan criteria, and patients were divided into 2 groups based on the presence of excessive joint laxity, group L (n = 13), or absence of excessive joint laxity, group N (n = 23). Functional assessments were performed with the patient-reported activity level; subjective shoulder value; Rowe score; and University of California, Los Angeles shoulder score.
RESULTS:The mean glenoid defect size was 25.1% (range, 20% to 29%), and the overall functional outcomes improved significantly after surgery. A return to greater than 90% of the premorbid activity level was reported by 72% of patients (26 of 36 patients), and patient satisfaction was 83% (30 of 36 patients). There was no significant difference in functional outcomes between groups L and N (subjective shoulder value, 85.0% for group L v 88.9% for group N, P = .397; Rowe score, 83.5 for group L v 92.8 for group N, P = .537; and University of California, Los Angeles shoulder score, 32.2 for group L v 31.9 for group N, P = .697). Recurrent instability occurred in 4 patients (11%), 3 patients in group L (3 of 13, 23%) and 1 patient in group N (1 of 23, 4%), but this difference was not statistically significant (P = .125).
CONCLUSIONS:Arthroscopic stabilization for recurrent shoulder instability in patients with moderate to low functional demand produced satisfactory outcomes despite the presence of moderate glenoid bone defects of 20% to 30%. For patients with excessive joint laxity, however, arthroscopic stabilization may not be reliable, with a recurrence rate of 23%.
LEVEL OF EVIDENCE:Level IV, therapeutic case series.
Full Text
http://www.sciencedirect.com/science/article/pii/S0749806314002515
DOI
10.1016/j.arthro.2014.03.023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99217
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