Reliability of the Instability Severity Index Score as a Predictor of Recurrence after Arthroscopic Anterior Capsulolabral Reconstruction: A Multicenter Retrospective Study

Abstract

BackgroundAlthough the instability severity index score (ISIS) is widely used to predict recurrence after arthroscopic anterior instability surgery, its reliability, especially on the weightings and cutoff values, is questionable. The goal of the current retrospective study was to investigate recurrence after arthroscopic capsulolabral reconstruction to evaluate whether each domain of the ISIS has the appropriate predictive power for recurrence by using logistic regression analyses with odds ratios (ORs).MethodsThis study included 120 consecutive patients who underwent arthroscopic capsulolabral reconstruction between 2004 and 2016. We retrospectively reviewed patients' preoperative history and radiographs, postoperative recurrence or sensation of instability, and risk factors related to the ISIS. The mean postoperative follow-up was 27.6 months (range, 12 to 96 months; median, 21 months). Twenty-six patients with recurrence or positive apprehension were classified as the recurrence group; 94 patients without any symptoms were classified as the non-recurrence group. Logistic regression analyses with ORs were used to verify the utility of each domain of the ISIS for predicting recurrence.ResultsThe mean ISIS did not differ significantly between the recurrence and non-recurrence groups (4.3 ± 1.8 vs. 3.4 ± 2.1 points; p = 0.063). Among the domains of ISIS, factors related to bone defects, the presence of a Hill-Sachs lesion and glenoid bone loss had the lowest ORs (0.77 and 0.38, respectively).ConclusionsNot all ISIS domains accurately predicted recurrence after arthroscopic capsulolabral reconstruction. The ISIS may not be a proper reference for determining Latarjet procedure in patients with anterior shoulder instability.

High Variability of the Definition of Recurrent Glenohumeral Instability: An Analysis of the Current Literature by a Systematic Review

“…On the Coleman methodology score, one scored poor, 11 43 studies scored fair, 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 37 scored good, 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ...…”

“… 63 48 35 + + Retrospective + + 1,2,3 1,2,3,4 1,2 73 Oh et al. 64 120 28 + + Retrospective + + 1,2,3 2,3,4 1,2 71 Ono et al. 65 51 121 + + Retrospective + + 1,2,3 1,3,4 1 70 Nakagawa et al.…”

“… 63 48 DS requiring revision surgery 1 (2) 3 (6) 1 (2) Oh et al. 64 120 Dislocation or positive apprehension 12 (10) 14 (12) 26 (22) Ono et al. 65 51 DS 9 (18) 7 (14) 16 (31) Nakagawa et al.…”

“…Moore et al 21 34 DS 1 (3) 2 (6) (9) Yapp et al 62 32 DS 4 (12) 3 (9) 7 (21) Rhee et al 63 48 DS requiring revision surgery 1 (2) 3 (6) (2) Oh et al 64 120 Dislocation or positive apprehension 12 (10) 14 (12)…”

Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

“…The arthroscopic treatment of anterior shoulder instability has become the preferred method for primary Bankart repair with reliable outcomes [1][2][3][4][5][6]. The advantages of arthroscopic repair for instability are the ability to accurately identify and treat the specific pathoanatomy, less iatrogenic damage to normal tissues, lower postoperative pain, and improved cosmesis.…”