Arthroscopic management of anterior labrum periosteal sleeve avulsion (ALPSA) lesions: A case series with improved clinical outcomes using a modified technique

Abstract

Introduction: Anterior labrum periosteal sleeve avulsion (ALPSA) is the avulsion of the labrum and of the non-disrupted periosteum with the subsequent healing of the labrum in a medialized nonfunctional position on the glenoid neck. Obejctive: In this study, a modified technique for arthroscopic repair of ALPSA lesions is presented, along with post operative clinical results and follow up. Method: 72 patients who underwent this procedure were included in this study. Patients with multidirectional instability, more than 20% of glenoid bone loss, and bony Bankart lesions were excluded. Results and conclusion: It was concluded that with this modified technique, a lower recurrence rate post arthroscopic repair of ALPSA lesions was seen with only 4 patients having postoperative recurrence of glenohumeral dislocation which amounts to 5.6%. Moreover, the data also showed a statistically significant improvement of 35.23% between the pre- and postoperative ASES scores.

Keywords

• Shoulder arthroscopy
• Anterior labrum periosteal sleeve avulsion
• Instability