McNamara John K, Sandler Alexis B, Scanaliato John P, Tyler John R, Boolani Ali, Parnes Nata
William Beaumont Army Medical Center/Texas Tech University Health Sciences Center El Paso, Department of Orthopaedic Surgery and Rehabilitation, El Paso, Texas, USA.
Carthage Area Hospital, Department of Orthopaedic Surgery, Carthage, New York, USA.
Orthop J Sports Med. 2025 Jun 17;13(6):23259671251342592. doi: 10.1177/23259671251342592. eCollection 2025 Jun.
Active-duty military servicemembers (ADSMs) exhibit a high prevalence of combined-type shoulder instability. Arthroscopic 270° labral repair has demonstrated promising outcomes at short- and intermediate-term follow-up, but there is a paucity of long-term outcomes data among ADSMs.
To report the outcomes of arthroscopic 270° labral repair at a minimum of 10-year follow-up in ADSMs.
Case series; Level of evidence: 4.
A total of 44 ADSMs who underwent arthroscopic 270° labral repair between January 2010 and December 2012 without major concomitant procedures had ≥10 years of follow-up and were deemed eligible for inclusion. Of these, 38 were included in the final outcome analysis.
Mean follow-up was 140.4 ± 14.4 months. Postoperatively, there was a statistically significant improvement in pain visual analog scale (VAS) scores (8.3 ± 1.3 to 1.63 ± 2.29; < .0001) as well as American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment (42.7 ± 12.3 to 87.3 ± 19.0; < .0001), Single Assessment Numeric Evaluation (SANE) (49.5 ± 18.9 to 91.9 ± 11.3; < .0001), and Rowe instability (45.3 ± 12.5 to 89.3 ± 19.2; < .0001) scores. There were no significant differences observed between pre- and postoperative range of motion. At final follow-up, 95% of patients met the minimal clinically important difference threshold for VAS, 89% for ASES, 92% for SANE, and 92% for the Rowe score; 58% met the substantial clinical benefit threshold for VAS, 61% for ASES, 11% for SANE, and 74% for Rowe scores; and 74% met the Patient Acceptable Symptom State threshold for VAS, 76% for ASES, 76% for SANE, and 74% for Rowe scores. At final follow-up, 89.5% of patients (n = 34) either returned to unrestricted duty or left the military for reasons other than continued shoulder-related disability, while 86.8% (n = 33) returned to unrestricted physical training. Two patients (5.3%) underwent reoperation, one requiring revision anterior labral repair and the other Latarjet after a traumatic dislocation of the operative shoulder.
Arthroscopic 270° labral repair demonstrates favorable clinical outcomes at a minimum 10-year postoperative follow-up in an active-duty military patient population, with clinically and statistically significant improvements in pain, patient-reported outcomes measures, and an overall return-to-duty rate of 89.5%.
现役军人（ADSMs）中复合型肩关节不稳定的患病率较高。关节镜下270°盂唇修复术在短期和中期随访中已显示出有前景的结果，但ADSMs中缺乏长期结果数据。
报告ADSMs中关节镜下270°盂唇修复术至少10年随访的结果。
病例系列；证据水平：4级。
2010年1月至2012年12月期间接受关节镜下270°盂唇修复术且无主要伴随手术的44例ADSMs，随访时间≥10年，被认为符合纳入标准。其中，38例纳入最终结果分析。
平均随访时间为140.4±14.4个月。术后，疼痛视觉模拟量表（VAS）评分（8.3±1.3至1.63±2.29；P<.0001）、美国肩肘外科医师（ASES）标准化肩部评估（42.7±12.3至87.3±19.0；P<.0001）、单评估数字评价（SANE）（49.5±18.9至91.9±11.3；P<.0001）和Rowe不稳定评分（45.3±12.5至89.3±19.2；P<.0001）均有统计学显著改善。术前和术后活动范围无显著差异。在最终随访时，95%的患者达到VAS最小临床重要差异阈值，89%达到ASES阈值，92%达到SANE阈值，92%达到Rowe评分阈值；58%达到VAS显著临床获益阈值，61%达到ASES阈值，11%达到SANE阈值，74%达到Rowe评分阈值；74%达到VAS患者可接受症状状态阈值，76%达到ASES阈值，76%达到SANE阈值，74%达到Rowe评分阈值。在最终随访时，89.5%的患者（n = 34）恢复了无限制服役或因非持续肩部相关残疾以外的原因离开军队，而86.8%（n = 33）恢复了无限制体能训练。两名患者（5.3%）接受了再次手术，一名需要翻修前盂唇修复术，另一名在手术侧肩部创伤性脱位后接受了Latarjet手术。
关节镜下270°盂唇修复术在现役军人患者人群术后至少10年的随访中显示出良好的临床结果，在疼痛、患者报告的结果指标方面有临床和统计学上的显著改善，总体复役率为89.5%。
