Arthroscopic Posterior Labral Repair of the Shoulder in Active-Duty Military Patients Shows Improvements in Patient-Reported Outcomes and High Return to Sports and Military Duty at a Minimum 10 Years Follow-Up.

Abstract

To evaluate patient-reported outcome measures (PROMs), clinically significant outcome (CSO) achievement rates, and return to sport (RTS), and military duty (RMD) rates at a minimum of 10 years following arthroscopic posterior labral repair in active-duty military service members (ADSM). Consecutive ADSM undergoing arthroscopic posterior labral repair between January 2010 and December 2013 at a single institution with a minimum 10-year follow-up were retrospectively evaluated. PROMs assessed included visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation (SANE), and the Rowe instability score. CSOs, return to sport, and return to military duty were also collected and assessed. A total of 39 patients met inclusion criteria with an average 140 months (11.7 years, range: 120-165) of follow-up. VAS, ASES, SANE, and Rowe scores all improved significantly postoperatively (VAS: 7.9 to 1.7, ASES: 46.7 to 87.8, SANE: 48.1 to 89.1, Rowe: 35.6 to 91.3; P < .0001 for all) at latest follow-up. All patients achieved the minimal clinically important difference, and the majority (62%-85%) achieved the patient acceptable symptomatic state for all PROMs. Achievement of substantial clinical benefit varied more considerably than the other measures (31%-69%). Across all clinical thresholds, a majority of patients (62%-100%) showed clinically significant improvements in pain as compared to preoperatively. In total, 92.3% (n = 36) of patients showed full return to military duty. Similarly, 87.2% (n = 34) reported return to sport including pushups at final follow-up. Following arthroscopic posterior labral repair of the shoulder, high-demand active-duty military patients sustain significant improvement in PROMs and high CSOs achievement rates at a minimum 10-year follow-up, alongside high rates of return to military duty and sports at 92.3% and 87.2%. Level IV, retrospective case series.