Artikel
Long-term functional, sports- and work-related outcomes after arthroscopic capsulolabral revision repair for recurrent anterior shoulder instability: A minimum 20-year follow-up
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Autoren
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Lukas Münch
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
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Isabella Kuhn
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
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Katrin Mitterpleininger
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
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Christoph Bartl
- ZOOOM, München, Germany
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Andreas B. Imhoff
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
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Bastian Scheiderer
- Abteilung für Sportorthopädie, Klinikum rechts der Isar, T, München, Germany
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Sebastian Siebenlist
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
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Marco-Christopher Rupp
- Klinikum rechts der Isar, Sektion für Sportorthopädie, München, Germany
| Veröffentlicht: | 21. Oktober 2024 |
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Gliederung
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Objectives: The purpose was to provide comprehensive, prospectively collected long-term functional outcomes, sports activity, and work ability of patients undergoing arthroscopic capsulolabral revision repair (ACRR) for recurrent anterior shoulder instability.
It was hypothesized that patients undergoing ACRR would maintain significant functional improvement along with a sufficient sports activity and work ability at a minimum follow-up of 20 years.
Methods: Patients who underwent ACRR for recurrent anterior shoulder instability between 09/1998 to 08/2003 and had a minimum follow-up of 20 years were analyzed. Functional outcome measures included Rowe, Constant-Murley (CM), and age-adjusted CM scores, as well as the visual analogue scale (VAS) for pain, which were collected preoperatively, at short-term follow-up (minimum 2 years) and at a minimum final follow-up of 20 years. The minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were calculated for the Rowe Score. The Single Assessment Numeric Evaluation (SANE) and Simple Shoulder Test (SST) scores were only collected at final follow-up. Return to sports and work, including sports and work level and discipline, were evaluated using a custom sports and work ability assessment tool.
Results and conclusion: Twenty-nine patients (mean age at surgery: 28.6±9.8 years) were included in the study, with a mean follow-up of 21.1±1.5 years (range: 20–24 years). The rate of recurrent instability was 27.6% (n=8), while 10.3% (n=3) subsequently underwent revision surgery. Younger age at surgery was significantly associated with failing after ACRR (p=0.042). The Rowe, CM, and age-adjusted CM score each significantly improved at both the minimum 2-year and minimum 20-year follow-up, when compared to preoperatively (p<0.001, respectively; Table 1 [Tab. 1]). Neither the CM (p=0.055), nor the age-adjusted CM (p=0.110), nor the Rowe (p=0.958) score differed significantly between the minimum 2-year and 20-year follow-up.
In conclusion, patients undergoing ACRR for recurrent anterior shoulder instability maintained significant improvement in functional outcomes at a minimum follow-up of 20 years, along with a rate of recurrent instability of 27.6%. Further, patients achieved a favorable postoperative sport activity and work ability.
