Arthroscopic anterior labral reconstruction using a transglenoid suture technique. Results in active-duty military patients.
We report the clinical outcome of arthroscopic labral reconstruction using a transglenoid suture technique in a young, active-duty military population. Forty-eight patients (49 shoulders) with varying degrees of glenohumeral instability underwent arthroscopic labral reconstruction using a transglenoid suture technique. All patients had traumatic injuries to their shoulders and all patients had magnetic resonance imaging scans demonstrating anterior labral tears. Postoperatively, the patients' shoulders were immobilized for up to 6 weeks. At a mean followup of 30 months (range, 12 to 49), 17 of the 41 patients (41%) with preoperative dislocation or subluxation had recurrent instability. Nine of these patients subsequently underwent open reconstruction procedures for recurrent instability. On the basis of the Rowe rating system, 53% had excellent or good results and 47% had fair or poor results. The overall perioperative complication rate was 14%. Suprascapular nerve palsy occurred in three cases (6%). Using the Fisher exact test, we determined that immobilization for 6 weeks postoperatively correlated with a lower recurrence rate in the patients with a history of glenohumeral dislocation (P = 0.007). The results of arthroscopic labral reconstruction using transglenoid sutures in the military patient are inferior to the reported 3% to 5% recurrence rate with open Bankart procedures, and the transglenoid pin technique jeopardizes the suprascapular nerve.
Mologne
T S
TS
Department of Orthopedic Surgery, Naval Medical Center, San Diego, CA 92134, USA.
Lapoint
J M
JM
Morin
W D
WD
Zilberfarb
J
J
O'Brien
T J
TJ
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001858:Bone Nails / Q000009:adverse effects; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D004204:Joint Dislocations / Q000209:etiology / Q000601:surgery; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D010243:Paralysis / Q000209:etiology; D011182:Postoperative Care; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D012421:Rupture; D012540:Scapula / Q000294:innervation; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000294:innervation / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome