Nonoperative Management for In-Season Athletes with Anterior Shoulder Instability

Buss, Daniel D.; Lynch, Gregory P.; Meyer, Christopher; Huber, Shane M.; Freehill, Michael Q.

doi:10.1177/0363546503262069

Cited by 193 publications

(126 citation statements)

References 13 publications

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“…1 Nonoperative management of glenohumeral instability has been associated with high rates of recurrence in multiples studies, with recurrence rates ranging from 37% to 85%. [2][3][4][5][6][7][8][9] Arthroscopic stabilization procedures have been similarly associated with recurrent instability, with recurrence rates ranging from 10.8% to 21.1%. [10][11][12][13] As a result, it has become essential for physicians to recognize clinical factors that place patients at increased risk of failed nonoperative or arthroscopic treatment.…”

mentioning

confidence: 99%

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

McHale

Sánchez

Lavery³

et al. 2017

Arthroscopy Techniques

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Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. The following Technical Note provides a diagnostic approach for suspected glenohumeral instability, as well as a detailed description of the congruent-arc Latarjet procedure, performed with a deltoid split, with its postoperative management.

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mentioning

confidence: 99%

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

McHale

Sánchez

Lavery³

et al. 2017

Arthroscopy Techniques

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“…At-risk athletes must be pain free and demonstrate symmetric shoulder strength within a functional range of motion that allows safe participation [70]. This typically entails a brief period of immobilization (3-10 days) followed by a progressive physical therapy protocol that focuses on cryotherapy, restoration of normal range of motion, rotator cuff and periscapular strengthening, stabilization drills, and finally, sport-specific drills over a 2-3-week period [71][72][73]. Dickens et al demonstrated that a period of immobilization is not necessary, and an accelerated rehabilitation program can be beneficial in a percentage of intercollegiate athletes with inseason anterior shoulder instability [74].…”

Section: Physical Therapymentioning

confidence: 99%

The Epidemiology and Natural History of Anterior Shoulder Instability

Galvin

Ernat

Waterman

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this review is to outline the natural history and best clinical practices for nonoperative management of anterior shoulder instability. Recent Findings Recent studies continue to demonstrate a role for nonoperative treatment in the successful long-term management of anterior glenohumeral instability. The success of different positions of shoulder immobilization is reviewed as well. Summary There are specific patients who may be best treated with nonoperative means after anterior glenohumeral instability. There are also patients who are not good nonoperative candidates based on a number of factors that are outlined in this review. There continues to be no definitive literature regarding the return to play of in-season athletes. Successful management requires a thorough understanding of the epidemiology, pathoanatomy, history, physical examination, diagnostic imaging modalities, and natural history of operative and nonoperative treatment.

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“…Depending on the sport and the functional limitations, the athlete may be allowed to continue participation. Again, MRI is required to confirm the diagnosis and treatment is dependent on the functional limitations of the athlete [41,42].…”

Section: Treatmentmentioning

confidence: 99%

Extremity trauma: field management of sports injuries

Wascher

Bulthuis

2014

Curr Rev Musculoskelet Med

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Traumatic injuries to the extremities are common in athletic competitions. The practitioner providing coverage of sporting events must be prepared to diagnose and provide initial treatment of these injuries. A thorough history and physical examination should result in a provisional diagnosis. Many injuries will require subsequent radiographs or orthopedic consultation. Limb threatening emergencies are rare but must be promptly recognized and referred to a hospital. Early treatment can protect athletes from further injury and may hasten their return to competition. Some athletes with extremity trauma can return to the contest, but this decision must be made on an individual basis.

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Nonoperative Management for In-Season Athletes with Anterior Shoulder Instability

Abstract: Most of the athletes were able to return to their sport and complete their seasons after an episode of anterior shoulder instability, although 37% experienced at least 1 additional episode of instability during the season.

Cited by 193 publications

References 13 publications

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

The Epidemiology and Natural History of Anterior Shoulder Instability

Extremity trauma: field management of sports injuries

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