Sex-Based Differences in Clinical Outcomes After Arthroscopic Anterior Shoulder Stabilization: Results at 5-Year Follow-up

Abstract

Background: The influence of patient sex on clinical outcomes after arthroscopic anterior shoulder stabilization is unclear. Purpose: To investigate sex-based differences in clinical outcomes after arthroscopic anterior shoulder stabilization. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was conducted among 76 patients who underwent arthroscopic anterior shoulder stabilization from February 2010 to December 2017. The patients were grouped by sex. The recurrence rate of instability was compared, as were pre- and postoperative pain scores, functional outcome scores, and active range of motion (ROM). Postoperative magnetic resonance imaging (MRI) was also performed for structural assessment of the glenohumeral joint. Results: No significant difference was found in the recurrence rate between female and male patients (13.3% vs 14.8%; P ≥.999; risk ratio, 1.107 [95% CI, 0.266-4.597]). Compared with male patients, female patients had a significantly lower preoperative Constant score (94.4 ± 6.4 vs 85.4 ± 11.1; P =.002), forward flexion (173.8° ± 10.7° vs 154.0° ± 33.8°; P =.011), abduction (171.0° ± 18.4° vs 142.7° ± 39.9°; P =.001), and external rotation (76.6° ± 21.6° vs 67.7° ± 20.4°; P =.037). Postoperatively, female patients had a significantly lower Simple Shoulder Test score compared with men (8.8 ± 1.9 vs 10.3 ± 1.6; P =.005). The mean changes from pre- to postoperative Rowe score (43.6 ± 21.4 vs 31.5 ± 19.8; P =.044), Constant score (9.9 ± 8.9 vs 0.8 ± 8.1; P =.002), forward flexion (24.0 ± 36.2 vs 4.2 ± 10.9; P =.013), abduction (36.0 ± 38.3 vs 7.6 ± 18.4; P