title: Results of revision anterior shoulder stabilization surgery in adolescent athletes.
abstract: OBJECTIVE
  The purpose of this study was to determine failure rates, functional outcomes, and risk factors for failure after revision anterior shoulder stabilization surgery in high-risk adolescent athletes.
  
  
  METHODS
  Adolescent athletes who underwent primary anterior shoulder stabilization were reviewed. Patients undergoing subsequent revision stabilization surgery were identified and analyzed. Failure rates after revision surgery were assessed by Kaplan-Meier analysis. Failure was defined as recurrent instability requiring reoperation. Functional outcomes included the Marx activity score; American Shoulder and Elbow Surgeons score; and University of California, Los Angeles score. The characteristics of patients who required reoperation for recurrent instability after revision surgery were compared with those of patients who required only a single revision to identify potential risk factors for failure.
  
  
  RESULTS
  Of 90 patients who underwent primary anterior stabilization surgery, 15 (17%) had failure and underwent revision surgery (mean age, 16.6 years; age range, 14 to 18 years). The mean follow-up period was 5.5 years (range, 2 to 12 years). Of the 15 revision patients, 5 (33%) had recurrent dislocations and required repeat revision stabilization surgery at a mean of 50 months (range, 22 to 102 months) after initial revision. No risk factors for failure were identified. The Kaplan-Meier reoperation-free estimates were 86% (95% confidence interval, 67% to 100%) at 24 months and 78% (95% confidence interval, 56% to 100%) at 48 months after revision surgery. The mean final Marx activity score was 14.8 (range, 5 to 20); American Shoulder and Elbow Surgeons score, 82.1 (range, 33 to 100); and University of California, Los Angeles score, 30.8 (range, 16 to 35).
  
  
  CONCLUSIONS
  At 5.5 years' follow-up, adolescent athletes had a high failure rate of revision stabilization surgery and modest functional outcomes. We were unable to convincingly identify specific risk factors for failure of revision surgery.
  
  
  METHODS
  Level IV, retrospective therapeutic case series.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Blackman
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Krych
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Kuzma
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Roxanne M
authors.initials: RM
authors.lastname: Chow
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Christopher
authors.initials: C
authors.lastname: Camp
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.. Electronic address: Dahm.Diane@mayo.edu.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Dahm
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods; D056352:Athletes; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D012008:Recurrence; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012782:Shoulder / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery; D013997:Time Factors; D017211:Treatment Failure