Suprascapular nerve injury during arthroscopic superior labral repair: a prospective evaluation
Bibliographic record
Abstract
PURPOSE: This prospective study evaluated suprascapular nerve injury risk during arthroscopic superior labral repair in patients of average height or shorter. METHODS: From 2009 to 2011, 12 patients <179 cm tall undergoing arthroscopic superior labral repair were prospectively enrolled. Portal location, tear and anchor characteristics, and surgeon impression of medial glenoid wall perforation were collected. Suprascapular nerve conduction studies were obtained postoperatively. A musculoskeletal radiologist evaluated medial glenoid wall perforation and the distance from the anchor to the suprascapular neurovascular bundle on postoperative magnetic resonance images (MRI). DASH scores were recorded preoperatively and 6 months postoperatively. RESULTS: Medial wall perforation occurred in five (42 %) patients, with 3 patients having a single perforation and two patients having two perforations. Eight of 38 (21 %) anchors drilled into the superior half of the glenoid, and 6 of 20 (30 %) anchors inserted into the postero-superior quadrant of the glenoid, perforated the medial wall. Perforations occurred both through the portal of Wilmington and the antero-superior portal. The distance to the suprascapular neurovascular bundle from the perforating anchors ranged from 0 to 4 mm. Nerve conduction studies revealed subclinical signs of an incomplete nerve injury in one patient. DASH scores improved on average 29.3 points postoperatively (SD = 27.0, p = 0.007). CONCLUSION: Medial wall perforation is common in smaller patients during arthroscopic superior labral repairs; the suprascapular nerve can be injured if perforation occurs. The clinical significance of these findings is unclear. In spite of a high drill-out rate, the nerve is rarely injured; however, an anchor designed for implantation into bone that is instead lodged in the soft tissues has the potential to harm these tissues and surrounding structures. LEVEL OF EVIDENCE: Prospective cohort study, treatment study, Level III.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".