KSSTA Knee Surgery, Sports Traumatology, Arthroscopy

DOI: 10.1007/s00167-013-2796-1

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Journal of arthroscopy and Joint Surgery

Purpose

To assess the effect of duration of symptoms, age and sex of the patients in predicting the outcome of surgery in arthroscopic sub-acromial decompression.

Type of study

Prospective study- Case series.

Materials & Methods

Fifty-one patients who underwent arthroscopic subacromial decompression procedure were followed up after surgery to assess the effect of duration of symptoms, age and sex on the outcome. Recovery period was assessed and reviewed for any effect of the predisposing factors.

Results

The duration of symptoms did not differ among different age groups and in either sex. The average duration of symptoms in either sex group was nearly equal. The average recovery time was 113 days for men and 125 days for women respectively. Statistically significant correlation was not found among either sex or in different age group in terms of recovery period and the length of symptoms prior to surgery.

Conclusion

This study has identified certain predictive factors such as age, gender and duration of symptoms prior to surgery which do not have any statistically significant impact on the length of recovery and outcome from shoulder surgery.

Bone Joint J 2014 96-B:(SUPP 1) 4.E

Introduction

Non-operative management of traumatic shoulder instability in children has a recurrence rate of up to 100%. Short-term outcomes of surgery in adults results has a quoted recurrence rates of around 10%.

The aim of this study was to examine the surgical outcomes of adolescent patients (aged 13 to 18 years) undergoing arthroscopic stabilisation for shoulder instability.

Methods

All patients had a labral tear sustained whilst participating in contact sports (84% rugby). Atraumatic, primary joint hyperlaxity and dyskinetic causes were excluded. All patients had a primary arthroscopic stabilisation. Patients were reviewed in clinic or contacted by post with a standardised outcome proforma.

Sixty one shoulders in 57 patients met the inclusion criteria and were included. Mean follow up was 22 months, mean age was 16.8 (range 13 to 18), and 98% were male. All were Stanmore type 1 pathology. 16% had a concomitant SLAP repair, and 16% had a posterior labral tear.

Results

31% (19) reported recurrent dislocation, and 11 patients required further surgery. This is significantly higher than published series for adults, despite the senior author being a tertiary specialist. Despite the high recurrence rate, the median improvement in shoulder function was 90% and the median VAS for pain was 0. The majority of patients (61%) had a full return to pre-injury sporting activities, while 23% returned to decreased sporting activity and 16% stopped. The mean post-operative Oxford instability score was 26.8 (SD 12.9 range 12 to 48). 90% of recurrent dislocations occurred whilst playing rugby, but other than this, we could not identify any significant risk factors for the 19 shoulders that had recurrent dislocations (gender, type of sport, hyper laxity, type of tear).

Conclusions

Adolescent patients have a high risk of recurrent dislocation following arthroscopic stabilisation.