Anterior Shoulder Instability In Patients Older Than 40 Years Treated With Arthroscopic Bankart Repair.

Autor: Doyle TR; UPMC Sports Surgery Clinic, Dublin, Ireland; Royal College Of Surgeons in Ireland, Dublin, Ireland; Department of Orthopaedic Surgery, Duke University, Durham, NC, USA. Electronic address: tomdoyle22@rcsi.com., Rotaru J; UPMC Sports Surgery Clinic, Dublin, Ireland., Landers S; UPMC Sports Surgery Clinic, Dublin, Ireland., Davey MS; UPMC Sports Surgery Clinic, Dublin, Ireland; Royal College Of Surgeons in Ireland, Dublin, Ireland., Kilkenny C; UPMC Sports Surgery Clinic, Dublin, Ireland; Royal College Of Surgeons in Ireland, Dublin, Ireland., Rasidovic D; UPMC Sports Surgery Clinic, Dublin, Ireland., Hurley ET; Department of Orthopaedic Surgery, Duke University, Durham, NC, USA., Mullett H; UPMC Sports Surgery Clinic, Dublin, Ireland; Royal College Of Surgeons in Ireland, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1016/j.jse.2024.09.022
Abstrakt: Introduction: Anterior shoulder instability in adults over the age of 40 is frequently managed non-operatively. There is limited published evidence for the surgical management of these patients. This study aims to assess the risk of recurrence and functional outcomes in older adults after Arthroscopic Bankart Repair (ARB).
Methods: A retrospective review of patients who underwent ARB under a single surgeon with a minimum of 2-year follow-up was performed. Recurrence, Visual Analogue Scale (VAS) for pain, satisfaction, Subjective Shoulder Value (SSV), Rowe and Constant scores, along with rate, level and timing of return to work and sport were evaluated.
Results: Overall, 51 patients who underwent ABR were included, there were 35 males (69%). The mean age was 46.9 ± 6.4 years, with mean follow-up of 77.9 ± 32.6 months (range 25-138 months). At final follow-up 88% (45/51) were either satisfied/very satisfied. The mean SSV was 87.4 ± 14, the mean Constant score was 80.4 ± 19.6, the mean Rowe score was 80.4 ± 19.6, while the mean VAS score was 2.2 ± 2.6. Overall, 45 of 47 (95.7%) patients returned to work at a mean of 5.7 ± 4.6 (0-16 weeks). Of the 43 patients playing sport preoperatively, 81.4% returned to play at a mean of 6.5 ± 3.8 months, 53.5% returned at the same level. However, only 27.3% of collision and 42.9% of overhead athletes returned at the same level. There were 4 patients (7.8%) who had a postoperative dislocation, all of which were traumatic. There were two revision (3.9%) arthroscopic stabilisations, whilst a total 8 patients (15%) had further procedures.
Conclusion: Arthroscopic stabilisation in patients older than 40 years of age results in a high rate of satisfaction, good functional outcomes and low pain scores at medium-to-long term follow-up. There was a high rate of return to play and work, although most returned to play at a lower level. There was a low rate of recurrent instability and a moderate rate of re-operation, with contact sports being the primary cause of recurrence.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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