Editorial Commentary: One to Two-Year Follow-up after Instability Surgery may be Similar, but Longer Follow-up Will Almost Certainly Show Diminished Patient Reported Outcomes as Recurrence Rates Increase.

Abstract

Multiple papers have looked at changes in Patient Reported Outcome Measures (PROMs) with time after a given intervention. For some interventions, such as total joint replacement, incremental changes in PROMs are modest after the first year. Instability surgery, in contrast, poses a risk of recurrence which increases each year, well after two-year follow-up. For arthroscopic Bankart repair, with minimum 10-year follow-up, recurrent instability occurred in 28% of patients, whereas only one-third of the recurrent instability events occurred in the first two-years, and 5-year follow-up showed only 76% survivorship. Activity modification was the major predictor of success. Reasonably responsive PROMs disease-specific to shoulder instability would be expected to reflect this risk, and not remain stable after one year post-operative.