Poster 217. Outcomes of Arthroscopic Treatment of 270-360 Degree Panlabral Tears

Eden Epner; Carolyn M. Hettrich; Brian R. Wolf; John E. Kuhn; Rick Wright; Charles Cox; Fidel Moreno; Keith M. Baumgarten; Shannon F. Ortiz; Lance E. LeClere; Peter S. Chang

doi:10.1177/2325967126S00513

Objective: Large labral lesions involving 270° to 360° of the glenoid are rare, inconsistently diagnosed, and present significant challenges in the management of shoulder instability. The purpose of this study was to evaluate short-term clinical outcomes, recurrent instability rate, and reoperation rates from a large multicenter database following arthroscopic repair of 270° and 360° pan-labral tears. Methods: Patients undergoing arthroscopic repair of 270° to 360° labral tears were identified from a large multicenter database. Outcomes assessed included the incidence of postoperative recurrent instability (dislocation or subluxation), reoperation rates, return to play, patient-reported outcomes (ASES, Shoulder Activity Score, WOSI, RAND-36, SANE, SST), as well as complication rates and surgical details at 2 years. Statistical analysis for demographics, injury characteristics, and outcomes utilized medians for continuous variables. Frequencies and proportions were utilized for categorical variables. Using Mood's Median Test, baseline and 2-year outcomes were compared. P-value <0.05 was considered statistically significant. STATA 18 was utilized to perform these analyses. Results: A total of 63 patients (median age 23 years, IQR 17-34; 90.5% male) with shoulder instability were included. Most were non-smokers (97%), and the median BMI was 25.6 kg/m². Family history of instability was present in approximately one-fourth of patients (24%). Injuries occurred in contact athletes (75%) and in those participating in overhead, throwing, serving, or swimming sports (71%). The dominant arm was affected in 56% of patients, and 18% were classified as hypermobile. At 2-year follow-up, median postoperative scores were: ASES 95 (p<0.001), SANE 90 (p<0.001), WOSI 86 (p<0.001), RAND-36 PCS 57 (p<0.001), and RAND-36 MCS 54 (p=0.469). Return to play was achieved in 75% of patients, of whom 91% returned to the same or higher level. Nineteen percent of patients (n = 12) experienced recurrent instability overall, and a minority (n = 5, 8%) ultimately required subsequent instability surgery. Two patients (3%) experienced a subsequent dislocation event. Conclusions: This series represents the largest cohort of 270°-360° labral tears in the literature. Over 90% of eligible patients completed patient-reported outcome measures at the specified follow-up interval. At two-year follow-up, arthroscopic repair of 270°-360° labral tears yields high rates of return to play and return to pre-injury activity. Patient-reported postoperative outcomes were excellent, with significant improvements from preoperative scores. The current cohort - composed predominantly of young, athletic, contact-sport individuals - achieved outcomes at the upper end of published success rates. Notably, the present results demonstrate lower rates of recurrent instability and reoperation compared to some earlier series, particularly in cohorts with rigorous follow-up and standardized surgical technique. Overall, these results underscore that, with modern arthroscopic techniques, even extensive labral pathology does not preclude excellent functional recovery and return to sport, while minimizing the risk of recurrence and re-operation two years post-operatively.

Poster 217. Outcomes of Arthroscopic Treatment of 270-360 Degree Panlabral Tears

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