title: Anterior labroligamentous periosteal sleeve avulsion lesion in arthroscopic capsulolabral repair for anterior shoulder instability.
abstract: OBJECTIVE
  This study aims to compare the associated lesions, clinical results, and postoperative recurrence rates in patients with ALPSA lesions (ALPSA group) versus those with Bankart lesions or Perthes lesions (Bankart group) in arthroscopic capsulolabral repair for anterior shoulder instability.
  
  
  METHODS
  Two hundred and twenty-two patients (227 shoulders) who had been followed for a minimum of 1 year were enrolled for this study. Mean age at the time of first dislocation was 19.5 ± 4.8 years. Mean age at the time of operation was 23.3 ± 4.6 years. One hundred and seventy-four shoulders were included in the Bankart group and fifty-three shoulders in the ALPSA group.
  
  
  RESULTS
  The mean preoperative number of dislocations was significantly higher in the ALPSA group with 12.3 ± 6.2 times than in the Bankart group with 6.9 ± 5.7 times. No statistically significant differences were found in final clinical results except postoperative loss of external rotation (P < 0.01) between the two groups. The ALPSA group had significantly higher rates of the lesion extended to the superior part of the 2 o'clock position (P < 0.01), synovitis (P < 0.01), glenoid erosion (P < 0.01), large Hill-Sachs lesions (P < 0.01), and engaging Hill-Sachs lesions (P = 0.03). The recurrence rate was 15.1% in the ALPSA group, more than twice the rate in the Bankart group with 7.4% (P = n.s.). The size and engagement of Hill-Sachs were significantly associated with redislocation (P < 0.01, P = 0.02).
  
  
  CONCLUSIONS
  Compared with the Bankart group, the ALPSA group showed a significantly higher number of preoperative dislocations, an associated larger-sized Hill-Sachs lesion, and a higher tendency to develop into an engaging Hill-Sachs lesion. In addition, the ALPSA group presented a higher tendency to redislocate and significant postoperative loss of external rotation after capsulolabral repair.
authors: Department of Orthopaedic Surgery, College of Medicine, Hanyang University, #17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Korea.
authors: Bong Gun
authors: BG
authors: Lee
authors: Nam Su
authors: NS
authors: Cho
authors: Yong Girl
authors: YG
authors: Rhee
references: Arthroscopy. 2004 Feb;20(2):169-74
references: 14760350
references: Arthroscopy. 2000 Oct;16(7):677-94
references: 11027751
references: Arthroscopy. 2008 Nov;24(11):1277-83
references: 18971059
references: Arthroscopy. 2002 May-Jun;18(5):469-82
references: 11987056
references: Instr Course Lect. 2010;59:245-53
references: 20415383
references: Arthroscopy. 2007 Sep;23(9):985-90
references: 17868838
references: Arch Orthop Trauma Surg. 2006 May;126(4):217-22
references: 16217670
references: Int Orthop. 2007 Oct;31(5):629-34
references: 17006660
references: Am J Sports Med. 2000 Mar-Apr;28(2):156-60
references: 10750990
references: Knee Surg Sports Traumatol Arthrosc. 2008 Feb;16(2):188-93
references: 18066527
references: Am J Sports Med. 2007 Apr;35(4):537-41
references: 17244898
references: J Bone Joint Surg Am. 2000 Jan;82(1):35-46
references: 10653082
references: J Shoulder Elbow Surg. 1999 Jan-Feb;8(1):66-74
references: 10077800
references: J Bone Joint Surg Am. 2001 Apr;83(4):621-2
references: 11315797
references: Arthroscopy. 1989;5(4):254-7
references: 2590322
references: Arthroscopy. 1993;9(1):17-21
references: 8442824
references: Am J Sports Med. 2008 Jun;36(6):1132-8
references: 18354146
references: J Shoulder Elbow Surg. 2007 Mar-Apr;16(2):188-92
references: 17399624
references: J Shoulder Elbow Surg. 2006 Sep-Oct;15(5):586-90
references: 16979054
references: Arthroscopy. 2007 Jul;23(7):703-9
references: 17637404
references: Am J Sports Med. 1997 Jul-Aug;25(4):449-53
references: 9240977
references: J Magn Reson Imaging. 2007 Oct;26(4):983-91
references: 17896393
references: Am J Sports Med. 2006 Jun;34(6):979-85
references: 16436537