Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study

doi:10.1016/j.arthro.2021.01.007

Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: To identify factors predictive of a large labral tear at the time of shoulder instability surgery. Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients undergoing open or arthroscopic shoulder instability surgery for a labral tear were evaluated. Patients with >270° tears were defined as having large labral tears. To build a predictive logistic regression model for large tears, the Feasible Solutions Algorithm was used to add significant interaction effects. Results: After applying exclusion criteria, 1235 patients were available for analysis. There were 222 females (18.0%) and 1013 males (82.0%) in the cohort, with an average age of 24.7 years (range 12 to 66). The prevalence of large tears was 4.6% (n = 57), with the average tear size being 141.9°. Males accounted for significantly more of the large tears seen in the cohort (94.7%, P =.01). Racquet sports (P =.01), swimming (P =.02), softball (P =.05), skiing (P =.04), and golf (P =.04) were all associated with large labral tears, as was a higher Western Ontario Shoulder Instability Index (WOSI; P =.01). Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (P =.007). Conclusions: Multiple factors were identified as being associated with large labral tears at the time of surgery, including male sex, preoperative WOSI score, and participation in certain sports including racquet sports, softball, skiing, swimming, and golf. Level of Evidence: I, prognostic study.

Original language	English
Pages (from-to)	1740-1744
Number of pages	5
Journal	Arthroscopy - Journal of Arthroscopic and Related Surgery
Volume	37
Issue number	6
DOIs	https://doi.org/10.1016/j.arthro.2021.01.007
State	Published - Jun 2021

Bibliographical note

Publisher Copyright:
© 2021 Arthroscopy Association of North America

Funding

Funding: Orthopaedic Research Education Foundation Grant 14-003 The authors report the following potential conflicts of interest or sources of funding: K.M.B. reports other, Arthrex , Wright State Medical Center. J.T.B. reports other, Smith & Nephew, DJO, Shukla Medical. B.T.F. reports grants, NIH , JSES, Current Reviews in Musculoskeletal Medicine; other, Kaliber, Bioniks. J.A.G. reports grants and personal fees, JRF Ortho; grants, Arthrex , Aesculap Biologics; personal fees, Conmed. C.A.J. reports grants, Smith & Nephew, Medtronic; grants and personal fees, Flexion Therapeutics; nonfinancial support, SOBI. R.G.M. reports personal fees, Journal of Bone and Joint Surgery, Journal of Bone and Joint Surgery Evidence-Based Orthopedics, Springer, Demos Health, MEND Nutrition. E.C.M. reports other, Zimmer Biomet; grants, Smith & Nephew, Arthrex , Mitek, Ossur. A.S.N. reports personal fees, Conmed. A.J.S. reports personal fees, Medacta, DJO. M.V.S. reports grants, National Science Foundation , PCORI; personal fees, Elite Orthopedics ( Arthrex ), Flexion Therapeutics. B.R.W. reports personal fees, ConMed, UnitedHealth Care. A.L.Z. reports personal fees, Stryker , Depuy-Mitek. R.W.W. reports grants, National Institutes of Health , National Institute of Arthritis and Musculoskeletal and Skin Diseases; personal fees, Wolters Kluwer Lippincott, Williams & Wilkins, Responsive Arthroscopy. Full ICMJE author disclosure forms are available for this article online, as supplementary material . The authors report the following potential conflicts of interest or sources of funding: K.M.B. reports other, Arthrex, Wright State Medical Center. J.T.B. reports other, Smith & Nephew, DJO, Shukla Medical. B.T.F. reports grants, NIH, JSES, Current Reviews in Musculoskeletal Medicine; other, Kaliber, Bioniks. J.A.G. reports grants and personal fees, JRF Ortho; grants, Arthrex, Aesculap Biologics; personal fees, Conmed. C.A.J. reports grants, Smith & Nephew, Medtronic; grants and personal fees, Flexion Therapeutics; nonfinancial support, SOBI. R.G.M. reports personal fees, Journal of Bone and Joint Surgery, Journal of Bone and Joint Surgery Evidence-Based Orthopedics, Springer, Demos Health, MEND Nutrition. E.C.M. reports other, Zimmer Biomet; grants, Smith & Nephew, Arthrex, Mitek, Ossur. A.S.N. reports personal fees, Conmed. A.J.S. reports personal fees, Medacta, DJO. M.V.S. reports grants, National Science Foundation, PCORI; personal fees, Elite Orthopedics (Arthrex), Flexion Therapeutics. B.R.W. reports personal fees, ConMed, UnitedHealth Care. A.L.Z. reports personal fees, Stryker, Depuy-Mitek. R.W.W. reports grants, National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases; personal fees, Wolters Kluwer Lippincott, Williams & Wilkins, Responsive Arthroscopy. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

Funders	Funder number
Current Reviews in Musculoskeletal Medicine
Flexion Therapeutics Inc.
JSES
MEND Nutrition
Smith & Nephew
UnitedHealth Care
National Science Foundation Arctic Social Science Program
National Institutes of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Orthopaedic Research and Education Foundation	14-003
Patient-Centered Outcomes Research Institute
Arthrex
Swedish Orphan Biovitrum AB

ASJC Scopus subject areas

Orthopedics and Sports Medicine

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Department of Orthopaedic Surgery Sports Medicine University of Kentucky (2021). Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study. Arthroscopy - Journal of Arthroscopic and Related Surgery, 37(6), 1740-1744. https://doi.org/10.1016/j.arthro.2021.01.007

Department of Orthopaedic Surgery Sports Medicine University of Kentucky. / Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder : A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2021 ; Vol. 37, No. 6. pp. 1740-1744.

@article{b34206c8000247f0bda34484d035f779,

title = "Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study",

abstract = "Purpose: To identify factors predictive of a large labral tear at the time of shoulder instability surgery. Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients undergoing open or arthroscopic shoulder instability surgery for a labral tear were evaluated. Patients with >270° tears were defined as having large labral tears. To build a predictive logistic regression model for large tears, the Feasible Solutions Algorithm was used to add significant interaction effects. Results: After applying exclusion criteria, 1235 patients were available for analysis. There were 222 females (18.0%) and 1013 males (82.0%) in the cohort, with an average age of 24.7 years (range 12 to 66). The prevalence of large tears was 4.6% (n = 57), with the average tear size being 141.9°. Males accounted for significantly more of the large tears seen in the cohort (94.7%, P =.01). Racquet sports (P =.01), swimming (P =.02), softball (P =.05), skiing (P =.04), and golf (P =.04) were all associated with large labral tears, as was a higher Western Ontario Shoulder Instability Index (WOSI; P =.01). Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (P =.007). Conclusions: Multiple factors were identified as being associated with large labral tears at the time of surgery, including male sex, preoperative WOSI score, and participation in certain sports including racquet sports, softball, skiing, swimming, and golf. Level of Evidence: I, prognostic study.",

author = "Cronin, {Kevin J.} and Magnuson, {Justin A.} and Wolf, {Brian R.} and Hawk, {Gregory S.} and Thompson, {Katherine L.} and Jacobs, {Cale A.} and Hettrich, {Carolyn M.} and Bishop, {Julie Y.} and Bollier, {Matthew J.} and Baumgarten, {Keith M.} and Bravman, {Jonathan T.} and Brophy, {Robert H.} and Cox, {Charles L.} and Feeley, {Brian T.} and Frank, {Rachel M.} and Grant, {John A.} and Jones, {Grant L.} and Kuhn, {John E.} and Ma, {C. Benjamin} and Marx, {Robert G.} and McCarty, {Eric C.} and Miller, {Bruce S.} and Neviaser, {Andrew S.} and Seidl, {Adam J.} and Smith, {Matthew V.} and Wright, {Rick W.} and Zhang, {Alan L.}",

note = "Publisher Copyright: {\textcopyright} 2021 Arthroscopy Association of North America",

year = "2021",

month = jun,

doi = "10.1016/j.arthro.2021.01.007",

language = "English",

volume = "37",

pages = "1740--1744",

number = "6",

}

Department of Orthopaedic Surgery Sports Medicine University of Kentucky 2021, 'Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study', Arthroscopy - Journal of Arthroscopic and Related Surgery, vol. 37, no. 6, pp. 1740-1744. https://doi.org/10.1016/j.arthro.2021.01.007

Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study. / Department of Orthopaedic Surgery Sports Medicine University of Kentucky.
In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 37, No. 6, 06.2021, p. 1740-1744.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder

T2 - A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study

AU - Cronin, Kevin J.

AU - Magnuson, Justin A.

AU - Wolf, Brian R.

AU - Hawk, Gregory S.

AU - Thompson, Katherine L.

AU - Jacobs, Cale A.

AU - Hettrich, Carolyn M.

AU - Bishop, Julie Y.

AU - Bollier, Matthew J.

AU - Baumgarten, Keith M.

AU - Bravman, Jonathan T.

AU - Brophy, Robert H.

AU - Cox, Charles L.

AU - Feeley, Brian T.

AU - Frank, Rachel M.

AU - Grant, John A.

AU - Jones, Grant L.

AU - Kuhn, John E.

AU - Ma, C. Benjamin

AU - Marx, Robert G.

AU - McCarty, Eric C.

AU - Miller, Bruce S.

AU - Neviaser, Andrew S.

AU - Seidl, Adam J.

AU - Smith, Matthew V.

AU - Wright, Rick W.

AU - Zhang, Alan L.

PY - 2021/6

Y1 - 2021/6

N2 - Purpose: To identify factors predictive of a large labral tear at the time of shoulder instability surgery. Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients undergoing open or arthroscopic shoulder instability surgery for a labral tear were evaluated. Patients with >270° tears were defined as having large labral tears. To build a predictive logistic regression model for large tears, the Feasible Solutions Algorithm was used to add significant interaction effects. Results: After applying exclusion criteria, 1235 patients were available for analysis. There were 222 females (18.0%) and 1013 males (82.0%) in the cohort, with an average age of 24.7 years (range 12 to 66). The prevalence of large tears was 4.6% (n = 57), with the average tear size being 141.9°. Males accounted for significantly more of the large tears seen in the cohort (94.7%, P =.01). Racquet sports (P =.01), swimming (P =.02), softball (P =.05), skiing (P =.04), and golf (P =.04) were all associated with large labral tears, as was a higher Western Ontario Shoulder Instability Index (WOSI; P =.01). Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (P =.007). Conclusions: Multiple factors were identified as being associated with large labral tears at the time of surgery, including male sex, preoperative WOSI score, and participation in certain sports including racquet sports, softball, skiing, swimming, and golf. Level of Evidence: I, prognostic study.

AB - Purpose: To identify factors predictive of a large labral tear at the time of shoulder instability surgery. Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients undergoing open or arthroscopic shoulder instability surgery for a labral tear were evaluated. Patients with >270° tears were defined as having large labral tears. To build a predictive logistic regression model for large tears, the Feasible Solutions Algorithm was used to add significant interaction effects. Results: After applying exclusion criteria, 1235 patients were available for analysis. There were 222 females (18.0%) and 1013 males (82.0%) in the cohort, with an average age of 24.7 years (range 12 to 66). The prevalence of large tears was 4.6% (n = 57), with the average tear size being 141.9°. Males accounted for significantly more of the large tears seen in the cohort (94.7%, P =.01). Racquet sports (P =.01), swimming (P =.02), softball (P =.05), skiing (P =.04), and golf (P =.04) were all associated with large labral tears, as was a higher Western Ontario Shoulder Instability Index (WOSI; P =.01). Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (P =.007). Conclusions: Multiple factors were identified as being associated with large labral tears at the time of surgery, including male sex, preoperative WOSI score, and participation in certain sports including racquet sports, softball, skiing, swimming, and golf. Level of Evidence: I, prognostic study.

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Department of Orthopaedic Surgery Sports Medicine University of Kentucky. Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study. Arthroscopy - Journal of Arthroscopic and Related Surgery. 2021 Jun;37(6):1740-1744. doi: 10.1016/j.arthro.2021.01.007

Male Sex, Western Ontario Shoulder Instability Index Score, and Sport as Predictors of Large Labral Tears of the Shoulder: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability Cohort Study

Abstract

Bibliographical note

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