Journal article
Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study
Journal of shoulder and elbow surgery, Vol.28(6), pp.1013-1021
06/2019
DOI: 10.1016/j.jse.2019.02.020
PMID: 31003889
Abstract
Male sex has been identified as a risk factor for both primary shoulder dislocation and recurrent instability, and male patients more often undergo surgery for instability. Despite published discrepancies between sexes regarding the incidence and surgical rates of shoulder instability, there is little detail on the differences in presentation, mechanism of injury, and intraoperative findings. The purpose of this study was to explore these differences.
Prospective baseline data from 1010 patients in the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort were analyzed for sex-related differences using demographic characteristics, patient-reported outcomes, radiographic findings, intraoperative findings, and surgical procedures performed. Two-tailed t tests and χ2 tests were used to compare the continuous and categorical data, respectively. Patients were categorized using the Frequency, Etiology, Direction, Severity (FEDS) classification system.
Male patients comprised 81.3% of the cohort. Male patients had a significantly higher rate of traumatic instability and rate of initial instability while playing sports, as well as significantly higher activity scores. Female patients had significantly lower preoperative American Shoulder and Elbow Surgeons, Western Ontario Shoulder Instability Index, 36-Item Health Survey, and Single Assessment Numeric Evaluation scores. No difference in the number of dislocations was found between male and female patients. Intraoperatively, male patients had higher rates of labral pathology and bone loss whereas female patients had higher rates of capsular laxity. These differences resulted in more Latarjet procedures for male patients and more soft-tissue procedures for female patients.
There are differences between male and female patients in the etiology of their instability, baseline patient-reported outcomes, and associated shoulder pathology, likely reflecting intrinsic and activity-related variation. These differences may influence clinical decision making and patient outcomes.
Details
- Title: Subtitle
- Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study
- Creators
- Justin A. Magnuson - University of KentuckyBrian R. Wolf - University of IowaKevin J. Cronin - University of KentuckyCale A. Jacobs - University of KentuckyShannon F. Ortiz - University of IowaJulie Y. Bishop - The Ohio State UniversityKeith M. Baumgarten - Orthopedic InstituteMatthew J. Bollier - University of IowaJonathan T. Bravman - Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USARobert H. Brophy - Washington University in St. LouisCharles L. Cox - Vanderbilt University Medical CenterBrian T. Feeley - University of California, San FranciscoJohn A. Grant - University of Michigan–Ann ArborGrant L. Jones - The Ohio State UniversityJohn E. Kuhn - Hospital for Special SurgeryC. Benjamin Ma - University of California, San FranciscoRobert G. Marx - Hospital for Special SurgeryEric C. McCarty - Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USABruce S. Miller - University of Michigan–Ann ArborAdam J. Seidl - Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USAMatthew V. Smith - Washington University in St. LouisRick W. Wright - Washington University in St. LouisAlan L. Zhang - University of California, San FranciscoCarolyn M. Hettrich - University of KentuckyMOON Shoulder Group
- Resource Type
- Journal article
- Publication Details
- Journal of shoulder and elbow surgery, Vol.28(6), pp.1013-1021
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jse.2019.02.020
- PMID
- 31003889
- ISSN
- 1058-2746
- eISSN
- 1532-6500
- Grant note
- DOI: 10.13039/100006307, name: ACL; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences; DOI: 10.13039/100007472, name: University of Kentucky
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984295053102771
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