Complex Labral Tears Are Not Predicted by Number of Preoperative Dislocations nor Time From Injury to Surgery in Patients Receiving Arthroscopic Anterior or Posterior Labral Repairs.

PURPOSE: To evaluate whether complex glenoid labral tears (i.e., those involving >120°of the glenoid labrum) are related to demographics, injury patterns, and surgical procedures/timing in patients undergoing primary arthroscopic labral repair.

METHODS

This retrospective chart review included patients with traumatic shoulder instability who underwent primary arthroscopic labral repair between 2012 and 2020. Patients with atraumatic multidirectional instability, clinical ligamentous laxity, or previous shoulder surgeries were excluded. Variables analyzed included age, sex, body mass index, contact sports participation, number of dislocations (<1, 1, 2, >2), direction of instability, labral tear size, time to surgery, number of anchors, and concomitant procedures. Complex labral tears involved >120° of the glenoid rim. Cohorts of "simple" anterior or posterior tears (<120°) were used for comparison. Statistical analyses used t tests, Mann-Whitney U, χ2, and the Fisher exact tests with a significance level of 0.05 and Bonferroni correction at 0.002.

RESULTS

In total, 477 patients (364 simple labral tear patients - 280 anterior and 84 posterior; 113 complex labral tear patients) met inclusion criteria (mean age: 27 years; range: 14-72 years). In all tear size groups, it was more common to have >2 dislocations than ≤2 dislocations (120° = 48.6%, 240° = 40.4%, 360° = 83.3%), but these differences were not statistically significant (P = .067). Time from first injury/instability event to surgery (in months) was not a predictor of tear size (simple = 45 ± 70 months, complex = 38 ± 67 months). There was no statistical difference between tear size groups and patient demographics in sex, contact sport participation, tobacco use, instability direction (anterior versus posterior), body mass index, age, or association of concomitant procedures. The number of anchors used was the only variable found to correlate with tear size (P < .001).

CONCLUSIONS

Complex glenoid labral tears did not correlate with the number of preoperative instability events, direction of instability, time to surgery, or previously cited factors such as contact sports or BMI in patients arthroscopically treated for shoulder instability.

LEVEL OF EVIDENCE: Level III, retrospective comparative cohort.