Arthroscopic Findings in Recurrent Shoulder Instability: Gender and Age-Related Differences of Anteroinferior Labrum Injuries

Abstract

Aim: Recurrent shoulder instability results in marked disability and affects mainly a young population. However, the gender and age-related differences in labral injuries have been underreported. The aim of our study is to evaluate the arthroscopic spectrum of anteroinferior labrum pathology in recurrent shoulder instability, and assess the gender and age-related differences. Method: This was a study of 201 consecutive patients who underwent arthroscopic shoulder stabilisation for recurrent shoulder instability. Patients were divided into two age groups. Group 1: under 35 years old, included 152 patients, mean age of 26.3 for both sex, and Group 2: over 35 years old, included 49 patients, mean age 42.2 for male and 47.6 for female patients. The gender and age-related differences of arthroscopic findings between the two age groups and overall gender differences were evaluated. Results: Female patients had significantly less antero-inferior labrum lesions (85.7% vs 96.2%, p < 0.011) and more isolated capsule-ligamentous laxity (11.9% vs 1.8%, p < 0.003), than male patients. When analysing the three subtypes of labrum injuries, female patients were found to have significantly less Bankart lesions than male patients (15.4% vs 36.5%, p < 0.037). Both male and female patients in Group 2, had significantly more ALPSA lesions (51% vs 31%, p < 0.0178), and less combined Bankart & Perthes lesions (40.8% vs 63.8%, p < 0.008), than Group 1. Conclusion: This study showed significant gender and age-related differences of anteroinferior capsule-labral complex injuries in chronic shoulder instability. We believe that increased awareness of the different pattern of injuries in female and older patients will be helpful in pre-operative planning and the implementation of the appropriate surgical management.