The Influence of Evidence-Based Surgical Indications and Techniques on Failure Rates After Arthroscopic Shoulder Stabilization in the Contact or Collision Athlete With Anterior Shoulder Instability
Bibliographic record
Abstract
BACKGROUND: It has been reported that arthroscopic shoulder stabilization yields higher rates of failure in contact or collision athletes as compared with open shoulder stabilization; however, this is largely based upon studies that do not employ modern, evidence-based surgical indications and techniques for arthroscopic shoulder stabilization. PURPOSE: To (1) determine the pooled failure rate across all studies reporting failure after primary arthroscopic shoulder stabilization for anterior shoulder instability in contact or collision athletes and (2) stratify failure rates according to studies that use evidence-based surgical indications and techniques. STUDY DESIGN: Systematic review. METHODS: A review of PubMed, Medline, and Embase was performed to identify all clinical studies with a minimum of 1-year follow-up that reported failure rates after arthroscopic shoulder stabilization for anterior shoulder instability in contact or collision athletes. Data pertaining to patient demographics, clinical and radiographic preoperative assessment, surgical indications, surgical technique, rehabilitation, and outcome were collected from each included study. An overall failure rate was determined across all included studies. After this, a secondary literature review was performed to identify factors related to patient selection and surgical technique that significantly influence failure after primary arthroscopic shoulder stabilization. Failure rates were then determined among included studies that used these evidence-based indications and techniques. RESULTS: Overall, 26 studies reporting on 779 contact or collision athletes met the inclusion criteria. The mean patient age was 19.9 years, 90.3% were male, and the most common sport was rugby. There was considerable variability in the reporting of patient demographics, preoperative assessment, surgical indications, surgical technique, and patient outcomes. Across all included studies, the pooled failure rate after arthroscopic shoulder stabilization in the contact or collision athlete was 17.8%; however, among studies that excluded patients with significant bone loss, used a minimum of 3 suture anchors, and performed the stabilization in the lateral decubitus position, the failure rate was 7.9%. CONCLUSION: The rate of failure after arthroscopic shoulder stabilization in contact or collision athletes decreases from 17.8% to 7.9% after the use of evidence-based surgical indications and techniques.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".