Female Sex, Reduced Glenoid Bone Width, and Glenoid Bone Loss Greater Than 11% to 15% May Increase the Risk of Failure After Arthroscopic Posterior Capsulolabral Repair: A Systematic Review.

Abstract

To identify and evaluate the most relevant preoperative risk factors for failure and revision surgery in patients undergoing primary arthroscopic capsulolabral shoulder repair for posterior shoulder instability (PSI). A systematic search of PubMed, MEDLINE library, and EMBASE from inception to April 2024 was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies assessing preoperative factors influencing failure or revision rates were included. Failure was defined as persistent pain or recurrent instability. The methodologic quality of the included studies was assessed using the Methodological Index for Non-randomized Studies (MINORS) scoring system. Nine articles published between 2016 and 2023 met the 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). Of the risk factors included, female sex, small glenoid bone width (<27.7 mm), and preoperative glenoid bone loss greater than 11% to 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 not to be significant risk factors for revision and/or failure. Female sex, small glenoid bone width, and greater than 11% to 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 appear to significantly influence outcomes. Level IV, systematic review of Level III and IV studies.