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Arthroscopic repair of HAGL lesions yields good clinical results, but may not allow return to former level of sport

journal contribution
posted on 2019-10-01, 00:00 authored by Uli Schmiddem, Adam Watson, Diana Perriman, Emmanouil Liodakis, Richard PageRichard Page
PURPOSE: There is a paucity of evidence regarding mid- to long-term clinical outcomes of arthroscopic repair of humeral avulsion of the glenohumeral ligament (HAGL). This study investigated clinical outcomes, return to sport and the frequency of associated shoulder lesions. METHODS: Eighteen patients underwent arthroscopic repair of a HAGL lesion between 2008 and 2015. Clinical outcome was evaluated using the Rowe Score, the Quick DASH Score (Q-DASH), the Oxford Shoulder Instability Score (OSIS), the ASES Score and Range of Motion (ROM). Return to sports and associated shoulder lesions were documented. RESULTS: Sixteen patients agreed to complete the shoulder scores and nine patients were available for clinical examination. Median time to follow-up was 59 months (range 16-104). The median Rowe Score and Q-DASH Score improved significantly from 33 to 85 points and 61 to 7 points, respectively (p = 0.001, p = 0.001). The median OSIS and ASES Score were 20 and 91 points. External rotation was significantly reduced compared to the contralateral side (p = 0.011). One recurrent dislocation was reported. No neurologic or vascular complications after surgery were reported. Five out of the nine patients did not return to sports at the same level. Associated shoulder lesions were found in 89% of the cases. CONCLUSION: Arthroscopic repair of a HAGL lesion is a reliable method to restore shoulder stability with good clinical results. However, limitations in external rotation and a reduction in sporting ability may persist at 59 months follow-up. Concomitant lesions are common. LEVEL OF EVIDENCE: Case series, level IV.

History

Journal

Knee surgery, sports traumatology, arthroscopy

Volume

27

Issue

10

Pagination

3246 - 3253

Publisher

Springer

Location

Berlin, Germany

eISSN

1433-7347

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)