Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up.
BACKGROUND
The purpose of this study was to evaluate prospectively the surgical outcomes of arthroscopic repair of anterior capsulolabral lesions with use of suture anchors in a large series of patients who were followed for two to six years.


METHODS
We evaluated the results of arthroscopic Bankart repair with use of suture anchors and nonabsorbable sutures in 167 patients with traumatic recurrent anterior instability of the shoulder. The mean age at the time of the operation was twenty-five years. Preoperatively and at the time of follow-up (at a mean of forty-four months), the patients were assessed with three objective outcome measurement tools (the Rowe score, the University of California at Los Angeles [UCLA] shoulder rating scale, and the American Shoulder and Elbow Surgeons [ASES] score) and two subjective measurement tools (pain and function visual analog scales). The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated.


RESULTS
All shoulder scores improved after surgery (p < 0.001). According to the Rowe scale, 130 patients (78%) had an excellent score; twenty-nine (17%), a good score; six (4%), a fair score; and two (1%), a poor score. Overall, the rate of postoperative recurrence of instability was 4% (one dislocation, two subluxations, and four positive results on the anterior apprehension test). Postoperative recurrence was related to an osseous defect of >30% of the entire glenoid circumference. In the patients with recurrent postoperative instability, the episodes were less frequent than they had been preoperatively and shoulder function was related to activity level. A revision arthroscopic Bankart repair stabilized three of the four shoulders in which it was performed. One hundred and fifty-two patients (91%) returned to >/=90% of their preinjury activity level. The mean loss of external rotation (and standard deviation) was 2.0 degrees +/- 4.0 degrees.


CONCLUSIONS
We found that, in contrast to previous reports on the results of arthroscopic repair, arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.
Kim
Seung-Ho
SH
Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. smcknot@hotmail.com
Ha
Kwon-Ick
KI
Cho
Yang-Bum
YB
Ryu
Byung-Dam
BD
Oh
Irvin
I
D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D055502:Secondary Prevention; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology; D013537:Sutures; D016896:Treatment Outcome