Outcomes of Arthroscopic Repair of Panlabral Tears of the Glenohumeral Joint (SS-03)

Abstract

Introduction Combined lesions of the glenoid labrum involving tears of the anterior, posterior, and superior labrum have been infrequently reported in the literature. The purpose of this study was to evaluate the clinical outcomes of arthroscopic repair of combined tears of the anterior, posterior, and superior labrum, including complications. Methods A retrospective review of 62 patients (56 male, 6 female) that underwent arthroscopic repair of combined tears of the anterior, posterior, and superior labrum was performed. The dominant arm was involved in 34/62 patients (54.8%). Eight shoulders had undergone at least one prior operation. Mean age at time of surgery was 30.8 years. Arthroscopic repair was performed in the beach chair (n=43) or lateral decubitus (n=19) position. The mean number of anchors per repair was 8.3 (5-13). Six patients underwent additional procedures in combination with labral repair; including glenoid (n=1) or humeral head microfracture (n=3), osteoarticular allograft of the humeral head (n=1), loose body removal (n=1), subacromial decompression (n=1), and rotator cuff repair (n=1). Postoperatively, outcomes were assessed by the American Shoulder and Elbow Surgeons (ASES) score and the Penn Shoulder score. Complications were documented, including need for revision surgery. Results Mean follow-up was 16 months. Mean ASES score at final follow-up was 92.3, and mean Penn Shoulder score was 92.8. A total of 4 complications developed in 4 patients (6.5%), with 2 requiring a return to surgery (3.2%). Two patients suffered a recurrent dislocation, one requiring revision arthroscopic Bankart repair. One patient developed symptomatic stiffness that required arthroscopic capsular release and lysis of adhesions. One patient developed drainage from an arthroscopic portal site that resolved with oral antibiotics. Conclusion Combined tears of the anterior, posterior, and superior glenoid labrum have not been commonly reported, therefore, care should be taken in the diagnosis and management of these lesions. Arthroscopic repair of combined tears can be performed with good postoperative outcomes and a low rate of complications, including recurrent instability.