Arthroscopic Repair of Type-V SLAP Lesion: A Prospective Cohort Study of an Anchor Above the Anterior Glenoid Mid-equator Based on a New Classification System

摘要

On basis of a newly proposed classification of type-V superior labrum anterior to posterior (SLAP) lesion, this study was conducted to investigate this question: “Does concurrent anterosuperior labral anchor repair limit postoperative range of external rotation and increase postoperative pain compared with isolated Bankart repair?.” This prospective cohort study, conducted between September 2014 and December 2017, included 20 patients who were divided into the following groups: group-S (12 patients) of concurrent Bankart and type-IIA SLAP repair by 3 anchors, with one of them above the glenoid mid-equator, and group-B (8 patients) of isolated Bankart repair by 2 anchors. Patients were evaluated for demographics and preoperative and 2-year postoperative shoulder range of motion, Rowe Instability Score, University of California Los Angeles score, and instability recurrence. Statistically, group-S patients had significantly older mean age at first time of dislocation (24.7 vs. 18.2y, respectively; P = 0.034). Post-operatively, there was an insignificant difference between groups with regard to external rotation deficits at 0 and 90 degrees abduction compared with sound contralateral shoulder (10.0 vs. 5.00 degrees; P = 0.080) and (17.1 vs. 12.5 degrees; P = 0.087), respectively. The current study demonstrated that concurrent Bankart and anterosuperior labral anchor repair can offer outcomes comparable to isolated Bankart repair as regards postoperative pain, range of external rotation, function, return to work, and instability recurrence. Age at first time of glenohumeral dislocation can be a predictor for severity of labral detachment. The currently reported classification system can assist in more precise decision making and outcome assessment of type-V SLAP repair. Level of Evidence: Level III.