The incidence of traumatic posterior and combined labral tears in patients undergoing arthroscopic shoulder stabilisation

Fagir M, Javed S, Gheorghiu D, Torrance E, Monga P, Funk L, Walton M

Background: Posterior and combined shoulder instabilities have been reported as accounting for only 2% to 5% of cases. More recently an increased incidence of posterior instability has been reported. We aim to assess the incidence in a large cohort of patients with surgically treated shoulder instability. The purpose of this study was to describe the demographics, incidence and nature of capsulolabral pathology in a large cohort of patients with surgically treated traumatic shoulder instability, both in sporting and non-sporting populations. Furthermore, we aimed to determine how often posterior and combined labral tears were treated compared with isolated anterior injuries.

Methods: This was a retrospective study which evaluated 442 patients who underwent an arthroscopic stabilisation surgery over a three-year period. Patients were categorised according to the location of their labral pathology and whether their injury was sustained during sporting or non-sporting activity. Proportions of labral tears between sporting and non-sporting populations were compared using the chi-square test.

Results: There were 442 primary arthroscopic labral repair procedures performed over the three-year period. Patients had a mean age of 25.9 years and 89.6% were male. Isolated anterior labral tears occurred in 52.9% with posterior and combined anteroposterior labral tears accounting for 16.3% and 30.8% respectively. The frequency of these lesions was greater in the sporting population (17.5% and 34.7%) compared to the non-sporting population (12.6% and 18.9%) (p=0.013).

Conclusion: Posterior and combined labral tears are more prevalent than previously reported, particularly in the sporting population.