Arthroscopic treatment of posterior shoulder instability in patients with and without glenoid dysplasia: a comparative outcomes analysis

• Published in: Journal of shoulder and elbow surgery 2017-12, Vol.26 (12), p.2103-2109
• Main Authors: Galvin, Joseph W., Morte, Douglas R., Grassbaugh, Jason A., Parada, Stephen A., Burns, Samuel H., Eichinger, Josef K.
• Format: Article
• Language: English
• Subjects: Adult; Arthroscopy; Follow-Up Studies; Glenoid Cavity - pathology; glenoid dysplasia; Humans; Joint Dislocations - complications; Joint Dislocations - surgery; Joint Instability - complications; Joint Instability - surgery; labral tear; Male; Mental Disorders - complications; Military Personnel; posterior instability; Reoperation; retroversion; Shoulder instability; Shoulder Joint - surgery; Treatment Outcome; United States; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2017.05.033

The purpose of this study was to evaluate the influence of glenoid dysplasia on outcomes after isolated arthroscopic posterior labral repair in a young military population. Thirty-seven male patients who underwent arthroscopic posterior labral repair for symptomatic posterior shoulder instability were evaluated at a mean duration of 3.1 years. A comparative analysis was performed for those with glenoid dysplasia and without dysplasia. Additional factors analyzed included military occupational specialty (MOS), preoperative mental health clinical encounters and mental health medication use, and radiographic characteristics (version, posterior humeral head subluxation, and posterior capsular area) on a preoperative standard shoulder magnetic resonance arthrogram. The groups were analyzed with regard to shoulder outcome scores (subjective shoulder value [SSV], American Shoulder and Elbow Surgeons [ASES] rating scale, Western Ontario Shoulder Instability Index [WOSI]), need for revision surgery, and medical separation from the military. Of 37 patients, 3 (8.1%) underwent revision surgery and 6 (16%) underwent medical separation. Overall outcome assessment demonstrated a mean SSV of 67.9 (range, 25-100) ± 22.1, mean ASES of 65.6 (range, 15-100) ±  22, and mean WOSI of 822.6 (range, 5-1854) ± 538. There were no significant differences in clinical outcome scores between the glenoid dysplasia and no dysplasia groups (SSV, P = .55; ASES, P = .57; WOSI, P = .56). MOS (P = .02) and a history of mental health encounters (P = .04) were significantly associated with diminished outcomes. The presence or absence of glenoid dysplasia did not influence the outcome after arthroscopic posterior labral repair in a young military population. However, a history of mental health clinical encounters and an infantry MOS were significantly associated with poorer clinical outcomes.