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Arthroscopy. 2014 Nov;30(11):1400-5. doi: 10.1016/j.arthro.2014.05.037. Epub 2014 Jul 30.

Results of revision anterior shoulder stabilization surgery in adolescent athletes.

Author information

  • 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
  • 2Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.. Electronic address: Dahm.Diane@mayo.edu.

Abstract

PURPOSE:

The purpose of this study was to determine failure rates, functional outcomes, and risk factors for failure after revision anterior shoulder stabilization surgery in high-risk adolescent athletes.

METHODS:

Adolescent athletes who underwent primary anterior shoulder stabilization were reviewed. Patients undergoing subsequent revision stabilization surgery were identified and analyzed. Failure rates after revision surgery were assessed by Kaplan-Meier analysis. Failure was defined as recurrent instability requiring reoperation. Functional outcomes included the Marx activity score; American Shoulder and Elbow Surgeons score; and University of California, Los Angeles score. The characteristics of patients who required reoperation for recurrent instability after revision surgery were compared with those of patients who required only a single revision to identify potential risk factors for failure.

RESULTS:

Of 90 patients who underwent primary anterior stabilization surgery, 15 (17%) had failure and underwent revision surgery (mean age, 16.6 years; age range, 14 to 18 years). The mean follow-up period was 5.5 years (range, 2 to 12 years). Of the 15 revision patients, 5 (33%) had recurrent dislocations and required repeat revision stabilization surgery at a mean of 50 months (range, 22 to 102 months) after initial revision. No risk factors for failure were identified. The Kaplan-Meier reoperation-free estimates were 86% (95% confidence interval, 67% to 100%) at 24 months and 78% (95% confidence interval, 56% to 100%) at 48 months after revision surgery. The mean final Marx activity score was 14.8 (range, 5 to 20); American Shoulder and Elbow Surgeons score, 82.1 (range, 33 to 100); and University of California, Los Angeles score, 30.8 (range, 16 to 35).

CONCLUSIONS:

At 5.5 years' follow-up, adolescent athletes had a high failure rate of revision stabilization surgery and modest functional outcomes. We were unable to convincingly identify specific risk factors for failure of revision surgery.

LEVEL OF EVIDENCE:

Level IV, retrospective therapeutic case series.

Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PMID:
25085048
[PubMed - in process]
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