Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports

Jobe, Frank W.; Giangarra, Charles E.; Kvitne, Ronald S.; Glousman, Ronald E.

doi:10.1177/036354659101900502

Cited by 395 publications

(206 citation statements)

References 24 publications

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“…4,[7][8][9]18 In our current study, we examined the functional outcomes of 130 overhead athletes undergoing TACS at a mean follow-up of 29 months (range, 15-47 months). The results of our study indicate superior outcomes to those which reported using open and arthroscopic stabilization procedures without TACS, 3,12,15,17,20,[22][23][24]29 and similar to those of Savoie and Field, 25 Lyons et al, 16 and Levitz et al, 14 which used TACS. Eighty-eight percent of patients had good-to-excellent results, with 87% returning to the same level of competition at a mean of 8.4 months postoperatively.…”

Section: Discussionsupporting

confidence: 82%

“…3,12,15,17,20,[22][23][24]29 Open surgical stabilization procedures have resulted in range-ofmotion complications and a low return to competition. 3,12,15,17,[22][23][24]29 Early outcome reports using the Bristow procedure by Lombardo et al 15 report a mean 11°loss of shoulder external rotation with 0% of overhead athletes returning to play at a mean follow-up of 17 months, while Torg et al 29 report 16% of athletes returned to throwing at a mean follow-up of 47 months. Using the capsular shift procedure, Rubenstein et al 24 reported a mean 2°loss of shoulder external rotation with 46% of professional baseball pitchers having excellent results at a mean follow-up of 39 months.…”

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confidence: 99%

“…Rowe et al 22 report 33% of throwers returning to their original level of competition at a mean follow-up of 72 months, while Rowe and Zarins 23 report 50% of patients returning to pitching at a mean follow-up of 48 months. Jobe et al 12 report 32% of patients not achieving full motion with a 13°mean loss of shoulder external rotation and 72% of overhead athletes returning to competition at a mean of 39 months. Similarly, Montgomery and Jobe 17 report a 1°mean loss of shoulder external rotation with 75% of baseball position players and 69% of pitchers returning to competition at a mean of 27 months.…”

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confidence: 99%

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Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Reinold

Wilk²,

Hooks³

et al. 2003

J Orthop Sports Phys Ther

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Study Design: Descriptive postoperative follow-up research. Objectives: The purpose of this investigation was to describe the return-to-competition rate and functional outcome of overhead athletes following arthroscopic thermal-assisted capsular shrinkage (TACS).Background: Traditional open procedures to correct instability in overhead athletes, such as capsulolabral repairs and capsular shifts, have produced less-than-favorable results, which have led to the development of TACS. Currently there are no long-term follow-up studies documenting the efficacy of this procedure in groups greater than 31 subjects or for a time period greater than 27 months. Methods and Measures: Two hundred thirty-one consecutive overhead athletes who due to symptoms of hyperlaxity had previously undergone a TACS procedure from 1997 to 1999 were selected for inclusion in the study. During a 1-month period, 130 of these athletes (mean age ± SD, 24 ± 6 years; 113 male, 17 female) were contacted by phone for follow-up at a mean of 29.3 months postoperatively (range, 15.4-46.6 months). Of the 130, 105 participated in baseball (80 pitchers), 14 in softball, 4 in football (quarterbacks), 4 in tennis, and 3 in swimming. Fifty-four (42%) subjects were professional, 49 (38%) collegiate, 16 (12%) high school, and 11 (8%) recreational athletes. One hundred twenty-three of the 130 (95%) underwent 1 or more concomitant procedure(s) at the time of TACS. Most commonly performed were labral debridements (69%), rotator cuff debridements (65%), and superior labral repairs (35%). Subjects who returned to competition were retrospectively evaluated using a modified Athletic Shoulder Outcome Rating Scale to subjectively assess pain, strength and endurance, stability, intensity, and performance. Overall results were based on a 90-point scale with scores of 80 to 90 representing excellent, 60 to 79 good, 40 to 59 fair, and less than 40 poor results. Results: One hundred thirteen out of 130 subjects (87%) returned to competition. Mean (±SD) time from surgery to return to competition was 8.4 ± 4.6 months. Mean outcome score for all subjects was 79/90; 75 (66%) subjects had excellent, 24 (21%) good, 11 (10%) fair, and 3 (3%) poor result. The mean outcome score for males was 80/90 and for females was 70/90.

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Section: Discussionsupporting

confidence: 82%

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confidence: 99%

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confidence: 99%

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Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Reinold

Wilk²,

Hooks³

et al. 2003

J Orthop Sports Phys Ther

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“…One of the main complications of any capsulolabral repair technique is loss of external rotation [16,34,45]. In previous series, loss of external rotation has ranged from 0°to 24° [16,27,44,45,47]. Early techniques of shoulder stabilization (ie, Bankart, Putti-Platt) used mediolateral retensioning, thus limiting external rotation.…”

Section: Discussionmentioning

confidence: 99%

Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Boileau¹,

Fourati²,

Bicknell³

2012

Clinical Orthopaedics &Amp; Related Research

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Background Neer modified the Bankart procedure by combining a superoinferior capsular shift with the labral reattachment. The theoretical advantages of the modification were that such a procedure would restore the patient's anatomy and also treat the repeated capsular stretching encountered in anteroinferior instability without limiting external rotation and, thereby reducing the risk of arthritis. Questions/purposes We therefore determined: (1) the rate of recurrent instability after this modification, (2) patient function, and (3) the incidence and stage of glenohumeral osteoarthritis at greater than 2 years followup in patients with traumatic anteroinferior instability. Methods We retrospectively reviewed all 64 patients (average age, 27 years) who had the modified Bankart procedure for recurrent dislocations (n = 39) or subluxation (n = 25) from 1991 to 1997. The labrum was reattached with suture anchors and a superoinferior capsular shift was added. We determined the rate of recurrent instability, Rowe and Walch-Duplay scores and shoulder ROM, and the presence of glenohumeral osteoarthritis (modified Samilson and Prieto classification). The minimum followup was 24 months (median, 40 months; range, 24-120 months). Results Recurrent instability occurred in seven of the 64 patients (11%) at an average of 25 months postoperatively (range, 7 days to 6 years); in six patients the recurrence was associated with trauma; five of the six patients underwent reoperation with a Latarjet procedure. Eight additional patients (13%) presented with persistent shoulder apprehension or discomfort. The average Rowe score was 83% (range, 20-100%) and average Walch-Duplay score 83% (range, 15-100%). However, only 36 of 64 (56%) patients could return to the same sport at the same level. The loss of external rotation was 13°compared with the contralateral side. Glenohumeral osteoarthritis incidence increased from 4% preoperatively to 17% postoperatively. Conclusions The open Bankart procedure modified by Neer provided high function scores but a relatively low rate of return to sport and high rate of recurrent instability. Our rate of recurrent instability, similar to that obtained with arthroscopic Bankart procedures, has prompted us to abandon the open procedure.

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“…The insufflations of the joint may have made the rotator cuff contact the superior glenoid at a higher angle than would occur physiologically when there is little fluid in the joint. However, a fluid pump has been used at the time of arthroscopy by others evaluating contact of the rotator cuff with the superior glenoid [7,15,17,18,24,35,37]. Second, it is possible making the measurements with the patients standing when awake and in the lateral position under anesthesia could have affected the results.…”

Section: Discussionmentioning

confidence: 99%

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Jia

Pannirselvam

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background One possible cause of shoulder pain is rotator cuff contact with the superior glenoid (cuff-glenoid contact) with the arm in flexion, as occurs during a Neer impingement sign. It has been assumed that the pain with a Neer impingement sign on physical examination of the shoulder was secondary to the rotator cuff making contact with the anterior and lateral acromion. Questions/purposes We determined if the arm position where pain occurs with a Neer impingement sign would correlate with the position where the rotator cuff made contact with the superior glenoid, as determined by arthroscopic evaluation. Patients and Methods We prospectively studied 398 consecutive patients with a positive Neer impingement sign during office examination and used a handheld goniometer to measure (in degrees of flexion) the arm position in which impingement pain occurred. During subsequent arthroscopy, the arm was moved into a similar position, and we measured the arm's position in flexion at the point the rotator cuff made contact with the superior glenoid using a handheld goniometer. We compared the degrees of flexion at which pain occurred preoperatively and at which there was cuff-glenoid contact.

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Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports

Cited by 395 publications

References 24 publications

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

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