title: Clinical outcomes following revision anterior shoulder arthroscopic capsulolabral stabilization.
abstract: BACKGROUND
  Traditionally surgeons have treated failed shoulder instability with open capsulolabral repair. Despite improved instrumentation, technique and familiarity in shoulder arthroscopy, few studies have reported the outcomes of arthroscopic revision shoulder instability repair. The purpose of this study was to assess clinical outcomes in patients following revision shoulder arthroscopic anterior capsulolabral stabilization.
  
  
  METHODS
  Sixty-two patients (63 shoulders) with failure of primary instability repairs were treated with revision arthroscopic anterior shoulder stabilization at a mean follow-up of 46.9 ± 16.8 months (range 18-78). Clinical outcomes were evaluated using validated patient-reported outcome questionnaires including the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, visual analog pain scale and Western Ontario Shoulder Instability Index. In addition, patients were queried for recurrent instability events (subluxation or dislocation) or revision surgery.
  
  
  RESULTS
  At final follow-up, the mean postoperative Western Ontario Shoulder Instability normalized score was 80.1 ± 18.7 (range 15.0-100). There were clinically significant improvements in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test scores and ten-point visual analog scale for pain (P < 0.001). Recurrent instability occurred in 12 shoulders (19.0 %), with number of prior surgeries and hyperlaxity found to be significant risk factor for failure (P < 0.001 and P = 0.04, respectively).
  
  
  CONCLUSIONS
  Revision arthroscopic anterior stabilization of the shoulder can result in satisfactory outcomes in appropriately selected patients who have failed previous capsulolabral repair. An increased number of prior surgeries and hyperlaxity are predictive of poor outcome.
  
  
  METHODS
  Case series, LOE IV.
authors.affiliation: Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, SK, Canada. jasonjwshin@gmail.com.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Randy
authors.initials: R
authors.lastname: Mascarenhas
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Anish V
authors.initials: AV
authors.lastname: Patel
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Yanke
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.affiliation: Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012782:Shoulder / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Revision surgery; Shoulder arthroscopy; Shoulder dislocation; Shoulder instability