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Anterior labroligamentous periosteal avulsion lesions may be associated with higher rate of recurrent dislocations than Bankart lesions following arthroscopic capsulolabral repair
Thursday, November 06 2008 | Comments
What's This?
In the study, researchers compared the outcomes of 99 patients (93 shoulders) who underwent either ALPSA lesion repair (26 shoulders) or discrete Bankart lesion repair (67 shoulders). The researchers evaluated the number of preoperative dislocations, postoperative recurrences, and the range of motion pre- and postoperatively. The subjects were followed up at 4 months, 6 months, 12 months, and then annually after the surgery.
The results showed that the average number of dislocations or subluxations was significantly higher in patients with ALPSA lesions (mean, 12.3 dislocations) than in patients with Bankart lesions (mean, 4.9 dislocations; P<.001). However, there were no significant between-group differences in the number of anchors used (P>.05), number of glenoid erosions (P>.05), or number of bony Bankart lesions (P>.05).
At an average follow-up of 47 months, 10 of the 93 shoulders (10.7%) had a recurrence of dislocation or subluxation. Five of these patients had Bankart lesions (7.4%) and 5 had ALPSA lesions (19.2%). The ALPSA group had a statistically significantly higher rate of recurrent instability following arthroscopic repair (P=.0501). Of the 10 patients with recurrent instability following the repair, 6 underwent revision surgery.
The investigators also found that 75 patients (79 shoulders) had good or excellent functional results. Specifically, 80.7% of shoulders in the ALPSA group and 86.5% of shoulders in the Bankart lesion group demonstrated such results.
"According to the results of this study, the recurrence of instability after arthroscopic capsulolabral repair for an ALPSA lesion is twice as high as the recurrence after repair of a classic Bankart lesion," the researches concluded. (Ozbaydar M, et al. Arthroscopy 2008;24:1277-1283.)
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