Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series

Nascimento, Alexandre Tadeu do; Claudio, Gustavo Kogake

doi:10.1016/j.rboe.2016.08.005

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ORIGINAL ARTICLES • Rev. bras. ortop. 51 (05) • Sep-Oct 2016 • https://doi.org/10.1016/j.rboe.2016.08.005 copy

Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series^☆ ☆ Work conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To evaluate the clinical results among patients undergoing arthroscopic repair of circumferential labral lesions.

METHODS:

This was a retrospective study on 10 patients who underwent arthroscopic repair to circumferential labral lesions of the shoulder, between September 2012 and September 2015. The patients were evaluated by means of the Carter-Rowe score, DASH score, UCLA score, visual analog scale (VAS) for pain and Short-Form 36 (SF36). The average age at surgery was 29.6 years. The mean follow-up was 27.44 months (range: 12-41.3).

RESULTS:

The mean score was 16 points for DASH; 32 points for UCLA, among which six patients (60%) had excellent results, three (30%) good and one (10%) poor; 1.8 points for VAS, among which nine patients (90%) had minor pain and one (10%) moderate pain; 79.47 for SF-36; and 92.5 for Carter-Rowe, among which nine patients (90%) had excellent results and one (10%) good. Joint degeneration was present in one case (10%), of grade 1. We did not observe any significant complications, except for grade 1 glenohumeral arthrosis, which one patient developed after the operation.

CONCLUSION:

Arthroscopic repair of circumferential labral lesions of the shoulder through use of absorbable anchors is effective, with improvements in all scores applied, and it presents low complication rates. Cases associated with glenohumeral dislocation have lower long-term residual pain.

Keywords:
Joint capsule; Joint instability; Shoulder joint; Arthroscopy; Retrospective studies

Patient	Age	Activity
1	52	Blue-collar worker
2	26	Athlete
3	41	Blue-collar worker
4	29	Athlete
5	18	Athlete
6	31	Athlete
7	32	Blue-collar worker
8	20	Athlete
9	18	Athlete
10	35	Blue-collar worker
Mean	30.2

	UCLA	DashH	Rowe	VAS
Pre-op	22.3 ± 3.8 (16–27)	40.2 ± 25 (10.83–75.83)	43.5 ± 22.5 (5–75)	6.8 ± 2.6 (3–10)
Post-op	32 ± 4.9 (19–35)	16 ± 23 (0.83–75.5)	92.5 ± 7.9 (75–100)	1.8 ± 2.15 (0–7)
p-Value	<0.000001	<0.009	<0.0001	<0.0001

SF-36	Functional outcome	Limited due to physical aspects	Pain	General health status	Vitality	Social aspects	Limitations due to emotional aspects	Mental health
Pre-op	78 ± 14.75 (55–100)	35 + 41.16 (0–100)	47.1 ± 17.1 (20–72)	78.1 ± 16.5 (55–97)	66 ± 22.5 (25–100)	73.7 ± 23.9 (37.5–100)	60 ± 46.6 (0–100)	74.2 ± 17.8 (48–96)
Post-op	88 ± 16.9 (55–100)	80 ± 42.1 (0–100)	75.1 ± 14.6 (41–90)	75.8 ± 14.7 (57–97)	75 ± 18.5 (40–90)	87.5 ± 14.4 (62.5–100)	80 ± 42.1 (0–100)	77.4 ± 13.6 (48–92)
p-Value	<0.044	<0.0187	<0.0032	0.316	0.3434	0.091	0.313	0.519

	UCLA	DashH	Rowe	VAS
Athletes	34.16 ± 0.7 (33–35)	4.44 ± 3.5 (0.83–10.83)	95 ± 5.4 (90–100)	0.5 ± 0.5 (0–1)
Blue-collar workers	28.75 ± 6.8 (19–34)	31.14 ± 32.8 (7.5–77.5)	88.75 ± 10.3 (75–100)	3.7 ± 2.2 (2–7)
	0.211	0.201	0.326217	0.058

	Functional outcome	Limited due to physical aspects	Pain	General health status	Vitality	Social aspects	Limitations due to emotional aspects	Mental health
Athletes	96.7 ± 4.08 (90–100)	100 ± 0 (100)	83.3 ± 5.16 (74–90)	85 ± 11.3 (67–97)	80 ± 10.4 (60–90)	95.83 ± 10.2 (75–100)	100 ± 0 (100)	85.6 ± 4.45 (80–92)
Blue-collar workers	75 ± 19.5 (55–100)	50 ± 57.7 (0–100)	62.75 ± 15.5 (41–74)	62 ± 4.08 (57–67)	60 ± 23.09 (40–80)	75 ± 10.2 (62.5–87.5)	50 ± 57.7 (0–100)	65 ± 13.6 (48–76)
p-Value	0.056	0.09	0.03	0.001	0.09	0.008	0.09	0.02

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: dr.nascimento@icloud.com(A.T. Nascimento).

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Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series☆ ☆ Work conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series^☆ ☆ Work conducted at the Hospital Orthoservice, Grupo de Ombro e Cotovelo, São José dos Campos, SP, Brazil.