scholarly journals Return to Sport Following Arthroscopic Repair of Anterior, Posterior, and Combined Shoulder Instability

2017 ◽  
Vol 33 (10) ◽  
pp. e62-e63
Author(s):  
Eric C. McCarty ◽  
Matthew J. Kraeutler ◽  
Nicholas Aberle ◽  
John B. Schrock ◽  
Colin C. Brown ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Arthroscopic Repair ◽  
Anterior Posterior

scholarly journals Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876375 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Nicholas S. Aberle ◽  
Colin C. Brown ◽  
Joseph J. Ptasinski ◽  
Eric C. McCarty
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Arthroscopic Stabilization ◽  
Shoulder Stabilization ◽  
Posterior Shoulder ◽  
Significant Difference ◽  
Patient Reported ◽  
Activity Scale ◽  
Anterior Posterior

Background: Glenohumeral instability is a common abnormality, especially among athletes. Previous studies have evaluated outcomes after arthroscopic stabilization in patients with anterior or posterior shoulder instability but have not compared outcomes between groups. Purpose: To compare return-to-sport and other patient-reported outcomes in patients after primary arthroscopic anterior, posterior, and combined anterior and posterior shoulder stabilization. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary arthroscopic anterior, posterior, or combined anterior and posterior shoulder stabilization were contacted at a minimum 2-year follow-up. Patients completed a survey that consisted of return-to-sport outcomes as well as the Western Ontario Shoulder Instability Index (WOSI), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Sur’geons (ASES) score, and Shoulder Activity Scale. Results: A total of 151 patients were successfully contacted (anterior: n = 81; posterior: n = 22; combined: n = 48) at a mean follow-up of 3.6 years. No significant differences were found between the groups with regard to age at the time of surgery or time to follow-up. No significant differences were found between the groups in terms of WOSI (anterior: 76; posterior: 70; combined: 78; P = .28), SANE (anterior: 87; posterior: 85; combined: 87; P = .79), ASES (anterior: 88; posterior: 83; combined: 91; P = .083), or Shoulder Activity Scale (anterior: 12.0; posterior: 12.5; combined: 12.5; P = .74) scores. No significant difference was found between the groups in terms of the rate of return to sport (anterior: 73%; posterior: 68%; combined: 75%; P = .84). Conclusion: Athletes undergoing arthroscopic stabilization of anterior, posterior, or combined shoulder instability can be expected to share a similar prognosis. High patient-reported outcome scores and moderate to high rates of return to sport were achieved by all groups.

scholarly journals Open Capsulorrhaphy for Recurrent Multidirectional Instability of the Shoulder

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110071
Author(s):  
Ioanna K. Bolia ◽  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Frank A. Petrigliano
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Young Female ◽  
Subscapularis Tendon ◽  
Shoulder Stabilization ◽  
Ehlers Danlos Syndrome ◽  
Physically Active ◽  
Recurrent Shoulder Instability ◽  
Multidirectional Instability

Background: The management of multidirectional instability (MDI) of the shoulder remains challenging, especially in athletes who participate in sports and may require multiple surgical procedures to achieve shoulder stabilization. Open or arthroscopic procedures can be performed to address shoulder MDI. Indications: Open capsulorrhaphy is preferred in patients with underlying tissue hyperlaxity and who had 1 or more, previously failed, arthroscopic shoulder stabilization procedures. Technique Description: With the patient in the beach-chair position (45°), tissue dissection is performed to the level of subscapularis tendon via the deltopectoral approach. The subscapularis tenotomy is performed in an L-shaped fashion, and the subscapularis tendon is tagged with multiple sutures and mobilized. Careful separation of the subscapularis tendon from the underlying capsular tissue is critical. Capsulotomy is performed, consisting of a vertical limb and an inferior limb that extends to the 5 o’clock position on the humeral neck (right shoulder). After evaluating the integrity of the labrum, the capsule is shifted superiorly and laterally, and repaired using 4 to 5 suture anchors. The redundant capsule is excised, and the subscapularis tendon is repaired in a side-to-side fashion, augmented by transosseous equivalent repair using the capsular sutures. Results: Adequate shoulder stabilization was achieved following open capsulorrhaphy in a young female athlete with tissue hyperlaxity and history of a previously failed arthroscopic soft tissue stabilization surgery of the shoulder. The athlete returned to sport at 6 months postoperatively and did not experience recurrent shoulder instability episodes at midterm follow-up. Discussion/Conclusion: Based on the existing literature, 82% to 97% of patients who underwent open capsulorrhaphy for MDI had no recurrent shoulder instability episodes at midterm follow-up. One study reported 64% return-to-sport rate following open capsulorrhaphy in 15 adolescent athletes with Ehlers-Danlos syndrome, but more research is necessary to better define the indications and outcomes of this procedure in physically active patients.

scholarly journals Return to Sport Following Open Latarjet Procedure for Recurrent Shoulder Instability

2021 ◽  
Vol 37 (1) ◽  
pp. e23
Author(s):  
Nikhil N. Verma ◽  
Joseph Liu ◽  
Ani Gowd ◽  
Grant Garcia ◽  
Alexander Beletsky ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Latarjet Procedure ◽  
Recurrent Shoulder Instability

An Analysis of the Rotator Interval in Patients With Anterior, Posterior, and Multidirectional Shoulder Instability

2008 ◽  
Vol 24 (8) ◽  
pp. 921-929 ◽  
Author(s):  
Matthew T. Provencher ◽  
Christopher B. Dewing ◽  
S. Josh Bell ◽  
Frank McCormick ◽  
Daniel J. Solomon ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Rotator Interval ◽  
Anterior Posterior

scholarly journals Outcomes and Return to Sport and Work After Open Bankart Repair for Recurrent Shoulder Instability: A Systematic Review

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110269
Author(s):  
Khalid AlSomali ◽  
Erica Kholinne ◽  
Thanh Van Nguyen ◽  
Chang-Ho Cho ◽  
Jae-Man Kwak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Return To Sport ◽  
Bankart Repair ◽  
Cochrane Library ◽  
Anterior Shoulder Instability ◽  
Functional Score ◽  
High Demand ◽  
Recurrent Instability ◽  
Instability Rate

Background: Open Bankart repair provides surgeons and patients with an alternative solution for managing recurrent instability in young athletes with or without minimal bone loss. Despite many studies that have reported low recurrence rates and good functional outcomes after open Bankart repair, we have limited knowledge about the return to sport and work for high-demand populations. Purpose: To assess the return to sport and work for high-demand populations after open Bankart repair for recurrent anterior shoulder instability, outcomes of open Bankart repair with regard to recurrence, and development of osteoarthritic (OA) changes. Study Design: Systematic review; Level of evidence, 4. Methods: We searched PubMed, EMBASE, Cochrane Library, Scopus, and Google Scholar databases using keywords as well as Medical Subject Headings terms and Emtree using “(Open Bankart OR Bankart surgery) (NOT arthroscopy NOT revision)” for English-language studies. We conducted a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: In total, 11 articles (10 with level 4 and 1 with level 3 evidence) including 563 patients (566 shoulders) were identified. The majority of patients were male (82%), the average age at the time of surgery was 27.4 years, and the mean follow-up was 11.5 years (range, 2.5-29 years). The most common functional score used was the Rowe score (95%) for the reported outcome measures, which showed good to excellent results (mean, 88.5 points). The overall recurrent instability rate, including dislocation and subluxation as a postoperative complication, was 8.5%. A total of 87% of patients were able to return to sport and work postoperatively. Overall, OA changes were reported in 33% of the patients, and the overall revision rate was 1%. Conclusion: Open Bankart repair exhibited favorable results, with a low postoperative instability rate. It is a reliable surgical procedure that allows high-demand patients to return to sport and work.

scholarly journals Variability in Rehabilitation Protocols after Superior Labrum Anterior Posterior Surgical Repair

2021 ◽  
Vol 14 ◽  
pp. 243-248
Author(s):  
Christina Hermanns ◽  
Reed Coda ◽  
Sana Cheema ◽  
Matthew Vopat ◽  
Armin Tarakemeh ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Surgical Repair ◽  
Return To Sport ◽  
Return To Sports ◽  
Biceps Tenodesis ◽  
Slap Repair ◽  
Rehabilitation Protocols ◽  
Google Search ◽  
Improve Patient ◽  
Anterior Posterior

Introduction. Rehabilitation after a superior labral anterior posterior (SLAP) repair is an important aspect of patient outcomes, however, no standardized rehabilitation protocol has been defined. The purpose of this paper is to assess the variability of rehabilitation after SLAP repair to understand the need for standardization to improve patient outcomes. Methods. Protocols for SLAP repairs were collected through a search for Academic Orthopedic Programs and a general google search using the terms “[Program Name (if applicable)] SLAP Repair Rehab Protocol”. Protocols were compared by sling, range of motion (ROM), physical therapy, return to sport (RTS), return to throwing, and biceps engagement/ biceps tenodesis recommendations. Protocols for non-operative or generalized shoulders were excluded.  Results. Sixty protocols were included. A total of 61.7% (37/60) recommended a sling for four to six weeks and 90% (54/60) included a full ROM recommendation, but time was variable. There were different exercises recommended, but pendulum swings were recommended by 53% (32/60), submaximal isometrics by 55% (33/60), and scapular strengthening by 65% (39/60). Of the sixty protocols, 33% (20/60) recommended return to sports in 24 weeks and 38.3% (23/60) recommended allowing throwing in 16 weeks. Conclusion. There was variability in protocols for SLAP repair, especially time until full ROM, RTS, and biceps strengthening. Time in sling and scapular strengthening were the least variable. A lack of specificity within protocols in what return to throwing meant for functional ability made it difficult to compare protocols. Considering the large number of Orthopedic programs, a relatively small number had published protocols. Further studies are needed to evaluate a standardized post-operative rehabilitation for SLAP repairs to improve outcomes.

scholarly journals Return to Sport as Outcome Measure for Shoulder Instability: Surprising Findings in Non-Operative Management in a High School Athlete Population

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0028
Author(s):  
Ellen Shanley ◽  
John M. Tokish ◽  
Charles A. Thigpen ◽  
Lauren Ruffrage ◽  
Douglas J. Wyland ◽  
...  
Keyword(s):  
High School ◽  
Shoulder Instability ◽  
Outcome Measure ◽  
Return To Sport ◽  
Operative Management ◽  
High School Athlete ◽  
Non Operative Management

scholarly journals Recurrence Rates Following Arthroscopic Shoulder Stabilization are Improved Following a Criteria Based Return to Sport Testing Protocol

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0038
Author(s):  
Adam Popchak ◽  
Kevin Wilson ◽  
Gillian Kane ◽  
Albert Lin ◽  
Mauricio Drummond
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Return To Play ◽  
Return To Sports ◽  
Recurrence Rates ◽  
Shoulder Stabilization ◽  
Recurrent Instability ◽  
Testing Protocol ◽  
Recurrent Shoulder Instability ◽  
Arthroscopic Shoulder Stabilization

Objectives: Recurrent shoulder instability after arthroscopic shoulder stabilization is a challenging complication that often manifests after return to sports. Many physicians use an arbitrary minimum of 5 months from surgery for clearance, although there is little data to support the use of temporal based criteria. Prior literature on ACL reconstruction has demonstrated overwhelming evidence for improved failure rates following return to sport after criteria based testing compared to time based clearance, but no such studies to date have evaluated the use of objective return to play testing protocols on recurrence rates following arthroscopic shoulder stabilization. We have prior presented on a return to sport criteria-based protocol that has demonstrated that a majority of athletes have residual strength and functional limitations which would preclude them from full clearance and return to play at 6 months postoperatively. The purpose of this study is to analyze the impact of a return to play criteria-based testing protocol on recurrent instability following arthroscopic shoulder stabilization. We hypothesized that patients who meet return to play criteria would have less recurrent instability compared to those who did not undergo the testing and were cleared to return based on time from surgery. Methods: Forty eight patients (group I) who underwent arthroscopic shoulder stabilization surgery from 2016 to 2018 with minimum 1 year follow up and were referred during postoperative rehabilitation for functional testing to evaluate readiness for return to sport were included in this retrospective case controlled study. These patients were compared to a control group of forty-eight historical consecutive cases (group II) who did not undergo return to sports testing and were cleared for sports after a minimum of 5 months following surgery. Patients with critical glenoid bone loss or off-track Hill-Sach’s lesions necessitating a remplissage or bone augmentation procedure were excluded from the study. ANOVA and independent t test were performed to analyze recurrence shoulder instability rates defined as dislocations or subluxation symptoms. Results: There was no difference between groups with regard to age ( p=0.64), sex (p=0.24), hand dominance (p=0.84), or participation in contact sports (p=0.66). Patients who underwent return to play criteria based testing protocol had a statistically significant difference in the rate of recurrent shoulder instability (10% vs. 31%, odds ratio=3.9, p<0.001). Conclusion: Athletes who undergo an objective return to play criteria based testing protocol have lower rates of recurrent instability following arthroscopic shoulder stabilization surgery than those cleared by time from surgery. Based on our findings, we strongly recommend the utilization of a criteria based testing protocol for return to play following arthroscopic shoulder stabilization, particularly for sports that have known higher risks of recurrence.

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