Anterior Shoulder Stabilization in Collision Athletes

Rhee, Yong Girl; Ha, Jeong Han; Cho, Nam Su

doi:10.1177/0363546505283267

Cited by 193 publications

(135 citation statements)

References 25 publications

(38 reference statements)

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Interpretation of our results would be incomplete without comparison to arthroscopic procedures. Although the reported recurrence rates after arthroscopic Bankart procedures were initially high, ranging from 7.5% to 49% [18,20,23,61], more recent studies have found improved recurrence rates, ranging from zero to 12.5% [4,15,17,29,32,46,56,58,62]. Our rate of recurrent instability after arthroscopic Bankart repair, using sutures and anchors, was 15% in 91 patients at 36 months followup [8].…”

Section: Discussionmentioning

confidence: 68%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 68%

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

View full text Add to dashboard Cite

show abstract

“…A systematic review by Brophy et al [53] reported instability following arthroscopic and open Bankart repairs to be comparable. However, a study by Rhee et al [54] reported a higher risk of failure with arthroscopic repair over open surgery in contact athletes although this was level 4 evidence. In patients with 15%-25% bone loss, management is dependent on the level of functional demand of the patient.…”

Section: Glenoid Bone Lossmentioning

confidence: 95%

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Ramhamadany

Modi

2016

WJO

View full text Add to dashboard Cite

The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

show abstract

“…One of them 30) demonstrated that both techniques yielded similar postoperative results, but recommended arthroscopic procedure because it can be performed safely. Another study 32) reported that no significance was found, but the authors mentioned that open is a more reliable method for collision athletes. One study 31) retrospectively reviewed outcomes of both procedures and found no significant difference between the two types of surgical procedures.…”

Section: Discussionmentioning

confidence: 95%

“…Open surgical techniques are also currently being used in treatment of first-time traumatic anterior shoulder dislocations. Many studies [29][30][31][32] have compared open surgical procedures with arthroscopic procedures for treatment of the same population as this review. However, these studies yielded different results.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review 29) pooled 19 studies, and concluded that arthroscopic surgery was associated with significantly higher risk of recurrent instability compared to the open surgical procedure. Two studies 30,32) were prospective RCTs. One of them 30) demonstrated that both techniques yielded similar postoperative results, but recommended arthroscopic procedure because it can be performed safely.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

Park

Cosby²

2016

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision. (Clin Shoulder Elbow 2016;19(2):110-116)

show abstract

Anterior Shoulder Stabilization in Collision Athletes

Cited by 193 publications

References 25 publications

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

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

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

Contact Info

Product

Resources

About