Outcomes of posterior labral repair with or without concomitant high-grade glenohumeral chondral pathology: a retrospective cohort with minimum 2-year follow-up

Young, Bradley L.; Corpus, Keith T.; Scarola, Gregory T.; Trofa, David P.; Connor, Patrick M.; Hamid, Nady; Piasecki, Dana P.; Saltzman, Bryan M.; Fleischli, James E.

doi:10.1016/j.jse.2021.04.030

Cited by 6 publications

(18 citation statements)

References 16 publications

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“…Initial review of the literature yielded 2,753 studies, with 17 full-text studies meeting inclusion criteria. There were 12 Level IV case series, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 3 Level III retrospective reviews, 36 , 37 , 38 and 2 Level II prospective cohort studies. 39 , 40 Twelve studies reported on knotted-only techniques, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 39 , 40 2 studies reported on knotless-only techniques, 34 , 35 and 3 studies reported on both knotted and knotless techniques.…”

Section: Resultsmentioning

confidence: 99%

“… 39 , 40 Twelve studies reported on knotted-only techniques, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 39 , 40 2 studies reported on knotless-only techniques, 34 , 35 and 3 studies reported on both knotted and knotless techniques. 36 , 37 , 38 Of the 3 studies that described both knotted and knotless suture techniques, 36 , 37 , 38 only 1 study 36 performed direct comparison of outcomes based on suture technique.…”

Section: Resultsmentioning

confidence: 99%

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No Difference in Recurrent Instability Between Knotted and Knotless Repair Techniques in Arthroscopic Treatment of Isolated Posterior Labral Tears: A Systematic Review

DeFoor,

McDermott,

Dickens

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

No Difference in Recurrent Instability Between Knotted and Knotless Repair Techniques in Arthroscopic Treatment of Isolated Posterior Labral Tears: A Systematic Review

DeFoor,

McDermott,

Dickens

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

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“…The inclusion criteria were (1) involvement of the supraspinatus, infraspinatus, and subscapularis tendons (AP-MRCT) and (2) having undergone arthroscopic rotator cuff repair. Patients were excluded from the study if they (1) underwent partial rotator cuff repair; (2) underwent biceps rerouting, graft bridging, or muscle tendon transfer; (3) had a fracture of the humeral head or scapula; (4) underwent additional procedures for shoulder instability; (5) had confirmed glenohumeral osteoarthritis (Outerbridge grade ≥3) 66 ; (6) had a history of ipsilateral shoulder surgery; or (7) were lost to follow-up within 24 months.…”

Section: Methodsmentioning

confidence: 99%

Effect of Anterior Acromial Coverage on Functional and Radiological Outcomes After Arthroscopic Repair of Anteroposterior Massive Rotator Cuff Tears

Ye,

Qiao,

et al. 2023

Am J Sports Med

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Background: Rotator cuff tear size, fatty infiltration, and scapular morphology are correlated with tendon healing and functional outcomes after arthroscopic repair; however, the association between anteroposterior acromial coverage and the clinical outcomes of anteroposterior massive rotator cuff tears (AP-MRCTs; involving all 3 tendons) remains unclear. Purpose: To identify the association between AP acromial coverage and functional and radiological outcomes after arthroscopic repair of AP-MRCTs. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 98 patients who underwent arthroscopic repair of AP-MRCTs between January 2015 and December 2020 were included in the study and classified according to whether anterior acromial coverage (AAC) was anterior (46 patients; positive AAC group) or posterior (52 patients; negative AAC group) to the scapular line on true lateral shoulder radiographs. Demographic characteristics, surgical details, and functional outcomes were prospectively collected. Acromial morphological features, global tear extension (GTE), the global fatty infiltration index (GFII), tendon integrity after repair, proximal humeral migration, and glenohumeral abduction were measured and calculated on radiographs or magnetic resonance imaging scans preoperatively and at 2 years postoperatively. Multivariate logistic regression was performed to identify the independent risk factors of a rotator cuff retear. Results: The positive AAC group showed larger AAC, posterior acromial tilt, and anterior acromial slope as well as smaller posterior acromial coverage compared with the negative AAC group. Postoperatively, the American Shoulder and Elbow Surgeons score (82.5 ± 8.3 vs 77.2 ± 11.5, respectively; P = .013), active abduction (157.8°± 27.1° vs 142.7°± 39.6°, respectively; P = .048), and glenohumeral abduction (45.6°± 10.4° vs 39.7°± 14.9°, respectively; P = .041) in the positive AAC group were significantly higher than those in the negative AAC group, while the retear rate (23.9% vs 44.2%, respectively; P = .035) and proximal humeral migration (1.7 ± 1.0 vs 2.3 ± 1.2 mm, respectively; P = .006) were significantly lower in the positive AAC group than in the negative AAC group. Smaller AAC (odds ratio [OR], 0.93 [95% CI, 0.87-1.00]; P = .040), larger GTE (OR, 1.03 [95% CI, 1.01-1.06]; P = .017), and a higher GFII (OR, 3.49 [95% CI, 1.09-11.19]; P = .036) were associated with an increased risk of a rotator cuff retear. Conclusion: Increased AAC was associated with a lower retear rate and better functional outcomes after arthroscopic repair of AP-MRCTs. A preliminary risk evaluation integrating GTE, the GFII, and AAC is recommended to consider the necessity of additional procedures for patients in need of arthroscopic rotator cuff repair.

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“…In these young, high-demand patients, timely operative intervention continues to gain traction as the preferred treatment option. 2,4,9,10,12,41,43,63 Timely arthroscopic stabilization serves to not only improve patient symptoms and reduce the risk of recurrent instability but also halt the development of glenoid bone loss typically encountered with chronic, recurrent instability. 11,44 While the results after anterior glenohumeral stabilization with labral repair have been well described, studies reporting patient outcomes after posterior labral repair remain sparse.…”

mentioning

confidence: 99%

“…19 In these young, high-demand patients, timely operative intervention continues to gain traction as the preferred treatment option. 2,4,9,10,12,41,43,63 Timely arthroscopic stabilization serves to not only improve patient symptoms and reduce the risk of recurrent instability but also halt the The American Journal of Sports Medicine 2022;50 (11):3036-3044 DOI: 10.1177/03635465221111568 Ó 2022 The Author(s)…”

mentioning

confidence: 99%

Arthroscopic Posterior Labral Repair in Active-Duty Military Patients: A Reliable Solution for an At-Risk Population, Regardless of Anchor Type

et al. 2022

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Background: Active-duty servicemembers are a population at risk for the development of posterior shoulder instability. While short-term outcomes after arthroscopic posterior labral repair for posterior shoulder instability are promising, there is a paucity of longer term follow-up data for this procedure. Purposes: The primary purpose was to report midterm outcomes after arthroscopic posterior labral repair in active-duty military patients for posterior shoulder instability without bone loss. The secondary purpose was to determine if outcomes varied between anchor types used. Study Design: Cohort study; Level of evidence, 3. Methods: Preoperative and postoperative outcomes, with a minimum 3-year follow-up, for a visual analog scale for pain, the Single Assessment Numeric Evaluation (SANE), the American Shoulder and Elbow Surgeons (ASES) score, and the Rowe score were collected and analyzed. A separate subgroup analysis was performed comparing the outcomes of patients who underwent repair with biocomposite anchors versus those who underwent repair with all-suture anchors. Results: A total of 73 patients with a mean follow-up of 82.55 ± 24.20 months met the inclusion criteria and were available for analysis. As a whole, the cohort demonstrated statistically and clinically significant improvements in outcome scores at final follow-up. Preoperative and postoperative range of motion did not vary significantly. While the difference in final outcome scores between the 2 anchor types did not reach statistical significance, a statistically significantly larger proportion of patients who underwent repair with all-suture anchors versus those who underwent repair with biocomposite anchors met the Patient Acceptable Symptom State for the SANE (97.14% vs 78.95%, respectively; P = .0180) and the ASES score (88.57% vs 68.42%, respectively; P = .0171). The proportion of patients who achieved the substantial clinical benefit or surpassed the minimal clinically important difference, however, did not vary by anchor type. Overall, 70 patients (95.89%) remained on active duty and were able to return to preinjury work and recreational activity levels. There were 3 patients (4.11%) who had recurrent posterior instability. Conclusion: This population of active-duty servicemembers undergoing posterior labral repair for posterior labral instability without bone loss demonstrated a statistically and clinically significant improvement in midterm outcomes, a low recurrence rate, and a rate of return to active duty of 95.89%, regardless of the anchor type used.

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Outcomes of posterior labral repair with or without concomitant high-grade glenohumeral chondral pathology: a retrospective cohort with minimum 2-year follow-up

Cited by 6 publications

References 16 publications

No Difference in Recurrent Instability Between Knotted and Knotless Repair Techniques in Arthroscopic Treatment of Isolated Posterior Labral Tears: A Systematic Review

No Difference in Recurrent Instability Between Knotted and Knotless Repair Techniques in Arthroscopic Treatment of Isolated Posterior Labral Tears: A Systematic Review

Effect of Anterior Acromial Coverage on Functional and Radiological Outcomes After Arthroscopic Repair of Anteroposterior Massive Rotator Cuff Tears

Arthroscopic Posterior Labral Repair in Active-Duty Military Patients: A Reliable Solution for an At-Risk Population, Regardless of Anchor Type

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