Several risk factors linked with failure after arthroscopic revision anterior stabilization

CHICAGO — Older patients and patients without off-track lesions or ligamentous laxity may have a lower rate of recurrent instability following arthroscopic revision anterior stabilization compared to patients with these risk factors, according to results presented here.

Of 92 patients with previous open or arthroscopic primary anterior stabilization with an anatomic procedure and arthroscopic revision anterior stabilization using standard suture anchor techniques during a 10-year period, Favian Ling-Fan Su, BS, and colleagues included 65 patients for analysis. Researchers measured glenoid and humeral bone loss and determined Hill-Sachs lesions. Overall, 89% of patients had MR arthrograms.

“Revision failure was defined as recurrent dislocation or subluxation,” Su said in his presentation at the Arthroscopy Association of North America Annual Meeting.

Results showed ligamentous laxity in 23% of patients and 32% of patients participated in contact sports. Su noted 50% of patients experienced glenoid bone loss with a mean defect size of 13.9%.

“Hill-Sachs lesions were present in 52% of patients with a mean width and depth of 15.2 [mm] and 4.8 mm, respectively,” Su said.

He added off-track Hill-Sachs lesions were identified in 24% of patients.

“At a mean follow-up of 4.7 years, 42% of patients had a failure,” Su said. “These failures occurred at a mean of 2.3 years following surgery.”

At more than 3-years post-revision, 37% of patients with failures had recurrent instability, Su noted. According to results of a multivariate analysis, independent predictors for failure included off track lesion, age younger than 22 years and ligamentous laxity.

“The mean age of patients who had recurrent instability was significantly less than those without recurrence,” Su said. “No significant difference was observed in the amount of glenoid and humeral bone loss between failure and non-failure groups. The failure rate among patients without independent risk factors was 19%.” – by Casey Tingle

Reference:

Su FLF, et al. Paper 67. Presented at: Arthroscopy Association of North America Annual Meeting; April 26-28, 2018; Chicago.

Disclosure: Su reports no relevant financial disclosures.