Posterior shoulder instability in throwing athletes: a case-matched comparison of throwers and non-throwers

McClincy, Michael P.; Arner, Justin W.; Bradley, James P.

doi:10.1016/j.jse.2015.11.025

Cited by 18 publications

(55 citation statements)

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“…Other athletes who are at risk of posterior labral injury are overhead athletes such as baseball players and swimmers. 8 Although not prominent in the literature, military personnel are likely also at increased risk of posterior labral tears owing to the extraordinary demands required of them. An epidemiologic study by Owens et al 11 identified 10.3% of overall shoulder instability to be posterior in the military population.…”

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confidence: 99%

Low Risk of Recurrence After Posterior Labral Repair of the Shoulder in a High-Risk United States Military Population

Chan

O’Brien

Waterman

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To examine the results of isolated arthroscopic posterior labral repair of the shoulder in an active military population, looking specifically at the reoperation rate and rate of return to previous military activity with a minimum follow-up period of 2 years. Methods: A retrospective case series was performed in active-duty military service members who underwent isolated, primary arthroscopic posterior labral repair at a single academic military treatment facility between 2009 and 2015 and had at least 2 years of follow-up. Patients were excluded if they were of noneactive-duty status, had insufficient follow-up (<2 years), or had undergone a concurrent procedure. Injury presentation, demographic data, and surgical data (i.e., surgical positioning, number of anchors, and anchor placement location) were compiled manually. Outcomes including the rate of return to active duty, recurrence of symptoms, and need for revision surgery were evaluated. Results: Sixty-five patients were included. After arthroscopic repair, a high rate of return to previous military duties (83%) was noted at short-to mid-term follow-up (mean AE standard deviation, 3.04 AE 1.30 years), with 1 patient (1.5%) requiring revision arthroscopic repair and 10 patients (15.5%) showing activity-limiting shoulder pain preventing a return to active duty. Intraoperative positioning (P ¼ .17), a low anchor position (P ¼ .27), and the number of anchors used (P ¼ .62) were not found to be significant contributors to continued postoperative pain or recurrent instability. Conclusions: Arthroscopic intervention resulted in a reliable rate of glenohumeral stability with a low rate of surgical revision and a high rate of return to military duty at short-to mid-term follow-up. However, 1 in 6 military service members showed significant, activity-limiting shoulder pain postoperatively that did not permit a return to previous military activities after surgical intervention. Level of Evidence: Level IV, therapeutic case series.

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confidence: 99%

Low Risk of Recurrence After Posterior Labral Repair of the Shoulder in a High-Risk United States Military Population

Chan

O’Brien

Waterman

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Although injuries to the superior and anterior labrum have historically received more attention, posterior labral injury and posterior instability have become increasingly recognized as a significant clinical entity. 9,15,17,30 Injuries to the posterior labrum in the baseball population commonly result from throwing, diving on the outstretched arm, or posterior subluxation of the lead shoulder during batting—so-called batter’s shoulder. 13,33 Although posterior labral tears can occur from an acute event, onset is commonly more insidious and related to repetitive microtrauma 27 and capsular contracture, which can lead to failure of the posterior capsulolabral structures.…”

mentioning

confidence: 99%

“…9 Studies are limited that specifically examine results of posterior labral repair isolated to baseball players. 13,17,33…”

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confidence: 99%

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

et al. 2019

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Background: There is a paucity of information regarding the treatment of posterior labral tears of the shoulder for baseball players. Reports regarding treatment and postoperative outcomes are more limited than its anterior and superior counterparts. Purpose: To evaluate the clinical presentation, surgical findings, postoperative outcomes, and rate of return to sport after arthroscopic repair of posterior labral injuries of the shoulder among baseball players. Study Design: Case series; Level of evidence, 4. Methods: Retrospective review was performed of baseball players who underwent arthroscopic posterior labral repair between 2009 and 2015 by a single surgeon, with a minimum 2-year follow-up. The group was composed of 32 male patients involved in recreational (6.3%), high school (43.8%), college (31.3%), and professional (18.8%) baseball, with a mean age of 20.5 years. Patients were categorized by chief complaint, clinical findings, surgical findings, and concomitant procedures performed. Pre- and postoperative measures included pain scale, range of motion, American Shoulder and Elbow Surgeons shoulder score, return to play, and patient satisfaction. Results: A variety of tear patterns were identified; 32% involved 90° of the posterior superior labrum; 35% involved the posterior 180°; and 32% involved 90° of the posterior inferior labrum. The dominant mechanism of injury was throwing (34.4%). The most common chief complaint was pain (n = 25, 78%), followed by pain and instability symptoms (n = 6, 18.8%), with only 3% citing isolated sensation of instability. Magnetic resonance imaging clearly identified tear patterns in 75% of cases. American Shoulder and Elbow Surgeons scores significantly improved ( P < .0001), increasing on average 30.9 points from the preoperative mean of 65.4 to a postoperative mean of 96.3. No significant range of motion deficits were noted. Tear size and number of anchors utilized did not influence outcomes. Ninety-four percent of athletes returned to play, 61% at previous levels, and 6% did not return. Pitchers had a lower return to previous level of play than position players (41% vs 86%, P = .0113). Conclusion: Arthroscopic treatment of posterior labral tears of baseball players was effective in improving pain and function, resulting in 94% patient satisfaction and 94% return to sport, with 61% returning to previous level of play. Patient presentation is variable, with a majority of patients citing pain rather than instability.

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“…In den meisten Fällen werden sie durch Überbelastung und die vielfache Wiederholung bestimmter Schulterbewegungen verursacht. Die beiden wichtigsten Ursachen oder beitragenden Faktoren sind das starke Ungleichgewicht zwischen Anta-und Agonisten des glenohumeralen Gelenks und die Schulterblatt-Dyskinesie [20].…”

Section: Schulterbeschwerden Bei Overhead Athletes Mit Gird-syndromunclassified

Orofaziale Behandlung von „Overhead Athletes“ mit langwierigem Schulterproblem (GIRD-Syndrom) – Multidisziplinäre Zusammenarbeit zwischen spezialisiertem Manualtherapeuten und Zahnarzt

Piekartz

Ruinemans²

2017

manuelletherapie

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Zusammenfassung Viele ?Overhead Athletes? leiden am Glenohumeral Internal Rotation Deficit Syndrome (GIRD; glenohumerales Innenrotationsdefizit). Die persistierenden Schulterbeschwerden werden durch ?berbelastung im oberen Quadranten verursacht. Bislang ist der Einfluss der orofazialen Region und der dentalen Okklusion auf die (motorische) Funktion bei den betroffenen Patienten nicht systematisch erforscht. Diese Fallserie untersuchte bei (semi)professionellen Overhead Athletes die Einschr?nkung ihrer Innen- und Au?enrotation sowie der statischen Kraft in 4 Bewegunsrichtungen. Aufgrund der Resultate wurde aus der 1. Gruppe eine 2. Gruppe gebildet, die 3 manualtherapeutische Behandlungen und anschlie?end eine Dentalschiene erhielt. Die multidisziplin?re Behandlung durch den Zahnarzt und einen (spezialisierten) Manualtherapeuten reduzierte signifikant die Beschwerden und Dysfunktionen. Eine orofaziale klinische Diagnose nach den Richtlinien der Diagnostic Criteria/Temporomandibular Dysfunctions (DC/TDM) und der okklusale kin?sthetische Sensibilisierungstest (OKST) scheinen prognostische Indikatoren f?r die Behandlung des GIRD-Syndroms zu sein.

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Posterior shoulder instability in throwing athletes: a case-matched comparison of throwers and non-throwers

Cited by 18 publications

References 0 publications

Low Risk of Recurrence After Posterior Labral Repair of the Shoulder in a High-Risk United States Military Population

Low Risk of Recurrence After Posterior Labral Repair of the Shoulder in a High-Risk United States Military Population

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

Orofaziale Behandlung von „Overhead Athletes“ mit langwierigem Schulterproblem (GIRD-Syndrom) – Multidisziplinäre Zusammenarbeit zwischen spezialisiertem Manualtherapeuten und Zahnarzt

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