title: Outcomes of arthroscopic repair of panlabral tears of the glenohumeral joint.
abstract: BACKGROUND
  Combined lesions of the glenoid labrum involving tears of the anterior, posterior, and superior labrum have been infrequently reported in the literature.
  
  
  OBJECTIVE
  To evaluate the clinical outcomes of arthroscopic repair of these lesions in a general population using validated scoring instruments, presence of complications, and need for revision surgery.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Fifty-eight patients who had arthroscopic labral repair of tears involving the anterior, posterior, and superior labrum (defined as a panlabral repair) were identified at our institution by retrospective review. All patients underwent arthroscopic labral repair with suture anchor fixation by a uniform approach and with a standardized postoperative protocol. Forty-four patients had a minimum 16-month postoperative follow-up. Outcomes were assessed postoperatively by the American Shoulder and Elbow Surgeons (ASES) score and the Penn Shoulder score. Complications were also documented, including need for revision surgery.
  
  
  RESULTS
  The mean age at the time of surgery was 32 years (range, 15-55 years) in the 44 patients. Presenting shoulder complaints included pain alone (40%), instability alone (14%), or pain and instability (45%). Mean number of anchors per repair was 7.9 (range, 5-12). Mean follow-up was 42 months (range, 16-78 months). Mean ± standard deviation ASES score at final follow-up was 90.1 ± 17.7 (range, 22-100), and mean Penn Shoulder score was 90.2 ± 15.3 (range, 38-100). Three of the 4 patients with outcome scores of 70 or less at final follow-up had undergone prior surgery. Thirteen postoperative complications (30%) occurred, with 3 (7%) requiring a second surgery. Five patients (11%) had an instability event following panlabral repair, but only 1 of these patients (2%) required revision surgery for a recurrent labral tear.
  
  
  CONCLUSIONS
  Combined tears of the anterior, posterior, and superior glenoid labrum represent a small but significant portion of labral injuries. Arthroscopic repair of these injuries can be performed with good postoperative outcomes and a low rate of recurrent labral injury.
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Ohio, USA. ricchee@ccf.org
authors.forename: Eric T
authors.initials: ET
authors.lastname: Ricchetti
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ciccotti
authors.forename: Daniel F
authors.initials: DF
authors.lastname: O'Brien
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: DiPaola
authors.forename: Peter F
authors.initials: PF
authors.lastname: DeLuca
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ciccotti
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Williams
authors.forename: Mark D
authors.initials: MD
authors.lastname: Lazarus
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult