Female Sex, Reduced Glenoid Bone Width, and a Glenoid Bone Loss Greater than 11-15% May Increase the Risk of Failure after Arthroscopic Posterior Capsulolabral repair: A Systematic Review.

PURPOSE

The purpose of this systematic review was to identify and evaluate the most relevant pre-operative risk factors for failure and revision surgery in patients undergoing primary arthroscopic capsulolabral shoulder repair for posterior instability (PSI).

METHODS

Following PRISMA guidelines, a systematic search of PubMed, Medline Library, and EMBASE from inception to April 2024 was conducted. Studies assessing preoperative factors influencing failure or revision rates were included. Failure was defined as persistent pain or re-instability. The methodological quality of the included studies was assessed using the MINORS scoring system.

RESULTS

Nine articles published between 2016 and 2023 met inclusion criteria. In total 960 patients were included. The mean patient age was 20.7 years (range, 12.4 - 65.0 years), 79.9% of patients were male, and the mean postoperative follow-up time was 5.3 years (range, 1.0 - 19.4 years). Out of the risk factors that were included, female sex, small glenoid bone width (less than 27.7 mm), and a pre-operative glenoid bone loss greater than 11-15 % were the only significant risk factors associated with failure and/or revision in patients undergoing arthroscopic capsulolabral repair for PSI. Glenoid version, type of sport, labral version, and labral width were found to not be significant risk factors for revision and/or failure.

CONCLUSION

Female sex, small glenoid bone width, and greater than 11-15% preoperative glenoid bone loss may be significant risk factors for failure or revision in arthroscopic capsulolabral repair for PSI. In contrast, glenoid version, type of sport, labral width, and labral version do not significantly influence outcomes.

LEVEL OF EVIDENCE

IV, Systematic review of level II IV studies.