Thank you very much. I'd like to acknowledge my co-authors from the University of Pittsburgh. Our disclosures are in the program. The literature currently endorses arthroscopic posterior capsular labor repair in both overhead as well as contact and collision athletes, with contact and collision athletes faring the best. Risk factors for posterior instability are not entirely known. There's a great study by Dr. Owens that we're well aware of that risk factors for developing posterior instability include increased squalenoid retroversion with every one degree of retroversion increase leading to 17% risk of repeat instability. Study by our group evaluating outcomes after surgery of 200 patients found decreased squalenoid bone width not versioned to be a risk factors for recurrence and poor outcomes. Good study by Dr. Tokish more recently showed that decreased return to duty was seen if patients had greater than 13.5% bone loss, but they didn't have any difference in their outcomes or revision rate. Therefore, the risk factors and outcomes aren't as well known as we'd hope for revision arthroscopic instability. We hypothesized that contact athletes who require revision arthroscopic posterior unidirectional capsular labor repair will have poor outcomes and return to play with risk factors for revision surgery including female gender, younger age, and decreased squalenoid bone width. We included contact athletes of any level with unidirectional posterior shoulder instability that underwent arthroscopic repair with minimum four-year follow-up. We excluded multidirectional instability patients and throwers who believe this is a different cohort. We've added rated risk factors, age, gender, level of sport, and injury type. We measured MRI measurements as we did in our 2016 study with version and width of the labral and the bone of the squalenoid. We evaluated postoperative outcomes and compared return to play and revision rate. Overall, we had 149 contact athletes with an average age of 18 years old with average follow-up of 13 years and a minimum follow-up of four years. Most of our athletes were high school athletes and the contact athletes had a revision rate of 5.4%. In regards to revisions, we found significantly worse pre-op stability in those patients that eventually required revision repair. We also saw significant difference in ASES scores between those that eventually required revision surgery. In regards to MRI evaluation, we found, again, decreased squalenoid bone width, which we saw seen in our previous study, which was a risk factor for developing issues. We found no difference in labral version. So for risk factors that were not significant regarding age, gender, level of sport, repair type or squalenoid version, those are not risk factors for revision. And our return to play at 13-year average follow-up was significantly different both overall and at the same level with revisions returning 50% of the time and 94% of the time overall. And we believe same level of return to play is one of the most important outcomes, which showed 17% with a revision group and 72% with a non-revision group. In conclusion, we had a revision rate of 5.4% of these contact athletes for posterior shoulder instability. We found the patients that eventually required revision surgery had significantly worse pre-operative stability scores, and the only significant risk factor for revision was smaller squalenoid bone width. And again, we found reverse, we found worse return to play in those that eventually required revision surgery. Thank you.

revision arthroscopic posterior capsular labral repair

contact athletes

posterior shoulder instability

revision rate

pre-operative stability scores