Glenoid track measurement using magnetic resonance imaging arthrography is predictive of recurrent instability following arthroscopic shoulder stabilisation
Purpose The primary aim of this study was to investigate medium-term survivorship following arthroscopic Bankart repair (ABR) for anterior glenohumeral instability. The secondary aim was to determine whether the pre-operative magnetic resonance (MR) arthrography glenoid track measurement predicted r...
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Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2022-10, Vol.32 (7), p.1313-1317 |
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Sprache: | eng |
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Zusammenfassung: | Purpose
The primary aim of this study was to investigate medium-term survivorship following arthroscopic Bankart repair (ABR) for anterior glenohumeral instability. The secondary aim was to determine whether the pre-operative magnetic resonance (MR) arthrography glenoid track measurement predicted recurrent instability following ABR.
Methods
Over a 9-year period (2008–2017), 215 patients underwent ABR. Median age was 26 years (IQR 22–32.5; range 14–77). There were 173 males (81%). 175 patients (81%) had available pre-operative MR arthrography, which was used to determine the presence of “off-track” bone loss. Retrospective analysis was undertaken to determine recurrence of instability at a median follow-up of 76 months (range 21–125 months). Survivorship analysis was undertaken using Kaplan–Meier methodology: the endpoints examined were repeat dislocation, revision stabilisation, and symptomatic instability.
Results
56 patients (26%) presented with further instability, including 29 patients with recurrent dislocation and 15 patients required revision stabilisation. Cumulative incidence of instability was 10% at 1 year, 27% at 5 years and 28% at 7 years. No significant difference in instability was seen between men and women 7 years after stabilisation (19% vs 17%;
p
= 0.87). Age at time of surgery did not predict recurrence.
“Off-track” lesions were identified in 29 patients (16.1%). The incidence of redislocation was significantly higher in these patients (24% vs 3%;
p
= 0.01; relative risk 7.2; 95% CI 2.45–20.5;
p
= 0.001). Recurrent instability without frank redislocation was also significantly higher in this group (60% vs 18%; RR 3.33, 95% CI 2.02–5.20;
p
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ISSN: | 1432-1068 1633-8065 1432-1068 |
DOI: | 10.1007/s00590-021-03100-2 |