TY - JOUR
T1 - Estimation of Location and Extent of Labral Tear Based on Preoperative Range of Motion in Patients Undergoing Arthroscopic Stabilization for Anterior Shoulder Instability
AU - MOON Shoulder Group
AU - Houck, Darby A.
AU - Dunn, Robin H.
AU - Hettrich, Carolyn M.
AU - Wolf, Brian R.
AU - Frank, Rachel M.
AU - McCarty, Eric C.
AU - Bollier, Matthew J.
AU - Kuhn, John E.
AU - Cox, Charles L.
AU - Ma, C. Benjamin
AU - Feeley, Brian T.
AU - Zhang, Alan L.
AU - Seidl, Adam J.
AU - Bishop, Julie Y.
AU - Jones, Grant L.
AU - Barlow, Jonathan D.
AU - Brophy, Robert H.
AU - Wright, Rick W.
AU - Smith, Matthew V.
AU - Marx, Robert G.
AU - Baumgarten, Keith M.
AU - Miller, Bruce S.
AU - Carpenter, James E.
AU - Grant, John A.
AU - Ortiz, Shannon F.
AU - Bravman, Jonathan T.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: Outside funding and grants received that assisted in this study are listed below along with the source of funding and grant number: An Orthopaedic Research Education Foundation Grant was received for financial assistance with this study. The grant number is: 14-003. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number ULlTR002537. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The study is supported by the National Institute of Health (NIH) Clinical and Translational Science Awards (CTSA) grant U54TR001356. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2020 Arthroscopy Association of North America. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: To determine whether range of motion (ROM) varies with the location and extent of labral tear seen in patients undergoing arthroscopic anterior shoulder stabilization. Methods: Consecutive patients undergoing arthroscopic anterior shoulder stabilization who were enrolled in the Multicenter Orthopaedic Outcomes Network Shoulder Instability database underwent a preoperative physical examination and intraoperative examination under anesthesia in which ROM was recorded. Intraoperatively, the location and extent of the labral tear was recorded using conventional clock-face coordinates. Patients were grouped by combinations of quadrants involved in the labral tear (G1-G7): G1 = anterior only, G2 = anterior + inferior, G3 = anterior + inferior + posterior, G4 = all quadrants, G5 = superior + anterior, G6 = superior + anterior + inferior, and G7 = posterior + superior + anterior. Statistical analyses were performed with the Kruskal–Wallis rank-sum test. When P <.05, a post-hoc Dunn's test was performed. For categorical variables, the χ2 test was performed. We performed a series of bivariate negative binomial regression models testing pairwise combinations of ROM parameters predicting the count of labral tear locations (possible: 0-5) within each quadrant. Results: A total of 467 patients were included, with 13 (2.8%) in G1, 221 (47.3%) in G2, 40 (8.6%) in G3, 51 (10.9%) in G4, 18 (3.9%) in G5, 121 (25.9%) in G6, and 3 (0.6%) in G7. Multiple statistically significant differences were noted in ROM, specifically active internal rotation at side (IRS) (P =.005), active abduction (P =.02), passive IRS (P =.02), and passive external rotation in abduction (P =.0007). Regression modeling revealed a positive correlation between passive abduction and predicted count of labral tear locations in the superior quadrant and between passive IRS and predicted count of labral tear location in the inferior quadrant. Conclusions: In patients undergoing arthroscopic shoulder stabilization for anterior instability, ROM varies with location and extent of labral tear. However, the clinical relevance of such small ROM differences remains undetermined. Level of evidence: II, prospective comparative study.
AB - Purpose: To determine whether range of motion (ROM) varies with the location and extent of labral tear seen in patients undergoing arthroscopic anterior shoulder stabilization. Methods: Consecutive patients undergoing arthroscopic anterior shoulder stabilization who were enrolled in the Multicenter Orthopaedic Outcomes Network Shoulder Instability database underwent a preoperative physical examination and intraoperative examination under anesthesia in which ROM was recorded. Intraoperatively, the location and extent of the labral tear was recorded using conventional clock-face coordinates. Patients were grouped by combinations of quadrants involved in the labral tear (G1-G7): G1 = anterior only, G2 = anterior + inferior, G3 = anterior + inferior + posterior, G4 = all quadrants, G5 = superior + anterior, G6 = superior + anterior + inferior, and G7 = posterior + superior + anterior. Statistical analyses were performed with the Kruskal–Wallis rank-sum test. When P <.05, a post-hoc Dunn's test was performed. For categorical variables, the χ2 test was performed. We performed a series of bivariate negative binomial regression models testing pairwise combinations of ROM parameters predicting the count of labral tear locations (possible: 0-5) within each quadrant. Results: A total of 467 patients were included, with 13 (2.8%) in G1, 221 (47.3%) in G2, 40 (8.6%) in G3, 51 (10.9%) in G4, 18 (3.9%) in G5, 121 (25.9%) in G6, and 3 (0.6%) in G7. Multiple statistically significant differences were noted in ROM, specifically active internal rotation at side (IRS) (P =.005), active abduction (P =.02), passive IRS (P =.02), and passive external rotation in abduction (P =.0007). Regression modeling revealed a positive correlation between passive abduction and predicted count of labral tear locations in the superior quadrant and between passive IRS and predicted count of labral tear location in the inferior quadrant. Conclusions: In patients undergoing arthroscopic shoulder stabilization for anterior instability, ROM varies with location and extent of labral tear. However, the clinical relevance of such small ROM differences remains undetermined. Level of evidence: II, prospective comparative study.
UR - http://www.scopus.com/inward/record.url?scp=85113982102&partnerID=8YFLogxK
U2 - 10.1016/j.asmr.2020.05.014
DO - 10.1016/j.asmr.2020.05.014
M3 - Article
AN - SCOPUS:85113982102
SN - 2666-061X
VL - 2
SP - e711-e721
JO - Arthroscopy, Sports Medicine, and Rehabilitation
JF - Arthroscopy, Sports Medicine, and Rehabilitation
IS - 6
ER -