Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study

Magnuson, Justin A.; Wolf, Brian; Cronin, Kevin; Jacobs, Cale A.; Ortiz, Shannon; Bishop, Julie Y.; Baumgarten, Keith M.; Hettrich, Carolyn M.; Bollier, Matthew; Bravman, Jonathan T.; Brophy, Robert H.; Cox, Charles L.; Grant, John A.; Jones, Grant L.; Kuhn, John E.; Benjamin, C.; Marx, Robert G.; McCarty, Eric C.; Miller, Bruce S.; Seidl, Adam J.; Smith, Matthew V.; Wright, Rick W.; Zhang, Alan L.

doi:10.1016/j.jse.2019.02.020

Cited by 23 publications

(14 citation statements)

References 27 publications

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“… 22 , 23 Although there is a lower incidence of shoulder instability in women, this population is still representative and is often associated with lower rates of return to sports. 16 , 19 , 21 , 22 Studies with athletes of both sexes often have female participants who experience longer periods of complaints of pain after the procedure or those who never return to the practice of sports. 9 , 25 However, this population is under-represented in the literature on orthopedic studies.…”

Section: Discussionmentioning

confidence: 99%

“…Aesthetic satisfaction after the Latarjet procedure has been discussed and analyzed over the past few years. 19 The deltopectoral approach to the shoulder, located on an interneural plane between the musculocutaneous and axillary nerves, is the standard approach for the open Latarjet procedure. 17 , 28 The incision leaves a scar at an exposed area of the body that may be related to lower aesthetic satisfaction, especially for young patients, or cicatrization complications such as keloids.…”

Section: Discussionmentioning

confidence: 99%

“… 23 , 24 Although there is a low incidence of shoulder instability in women, this population is still representative and is often associated with lower rates of return to sports. 19 Few studies have evaluated the results of Latarjet surgery in female athletes.…”

mentioning

confidence: 99%

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Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study

Lima¹,

Osés²,

Godoy³

et al. 2022

JSES International

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study

Lima¹,

Osés²,

Godoy³

et al. 2022

JSES International

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“…The difference between the sexes associated with shoulder instability has been reported previously. 14 , 15 , 19 , 26 , 35 Female athletes participating in soccer, basketball, and rugby have been reported to have a higher risk of shoulder dislocation compared with their male counterparts. 23 , 27 The Multicenter Orthopaedic Outcomes Network study group reported that capsular laxity was higher in females, whereas labral pathology and bone defect were higher in males.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of Anterior Humeral Head Translation in Patients With Anterior Shoulder Instability: Correlation With Demographic, Radiographic, and Clinical Data

Inoue

Takenaga

Tsuchiya

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Ultrasonography can be used to quantitatively assess anterior humeral head translation (AHHT) at different degrees of shoulder abduction. Risk factors for recurrent shoulder instability have been identified. Hypothesis: It was hypothesized that the number of dislocations or glenoid or humeral bone loss would be associated with more AHHT as measured using ultrasound. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 39 patients who underwent surgery for anterior shoulder instability were prospectively studied. Ultrasound assessment of AHHT was performed immediately after general anesthesia was induced. The upper arm was placed at 0°, 45°, and 90° of abduction, and a 40-N anterior force was applied to the proximal third of the arm. The distance from the posterior edge of the glenoid to that of the humeral head was measured at each abduction angle using ultrasound with and without a 40-N anterior force, and the AHHT was calculated. The differences in translation at each shoulder angle were compared. Additionally, the authors investigated the association between AHHT and demographic, radiographic, and clinical data. Results: Compared with the AHHT at 0° of abduction (5.29 mm), translation was significantly larger at 45° of abduction (8.90 mm; P < .01) and 90° of abduction (9.46 mm; P < .01). The mean translation was significantly larger in female patients than in male patients at all degrees of abduction ( P ≤ .036 for all). There was no correlation between AHHT at any abduction angle and number of dislocations, clinical data, or radiographic data (including bone loss). Conclusion: Ultrasound assessment of AHHT showed larger amounts of laxity at 45° and 90° than at 0° of abduction. Anterior glenohumeral laxity was greater in female than male patients. Glenoid or humeral bone loss did not correlate with AHHT, thereby clarifying that bone loss has no direct effect on measurements of capsular laxity in neutral rotation.

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“…20 Multidirectional instability is often associated with ligamentous laxity, whereas unidirectional instability 12,19 is more traumatic in etiology. 9,14,19 The frequency, etiology, chronicity, severity, and direction 12 of instability are other important descriptors.…”

mentioning

confidence: 99%

Athletes diagnosed with anterior and posterior shoulder instability display different chief complaints and disability

Teske

Arvesen

Kissenberth

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Anterior shoulder instability is a common complaint of young athletes. Posterior instability in this population is less well understood, and the standard of care has not been defined. The purpose of the study is to compare index frequency, treatment choice, and athlete disability following an incident of anterior or posterior shoulder instability in high school and collegiate athletes. Methods: A total of 58 high school and collegiate athletes (n¼30 athletes with anterior instability; n¼28 athletes with posterior instability) were included. Athletes suffering from a traumatic sport-related shoulder instability episode during a team-sponsored practice or game were identified by their school athletic trainer. Athletes were referred to the sports medicine physician or orthopedic surgeon for diagnosis and initial treatment choice (operative vs. nonoperative). Athletes diagnosed with traumatic anterior or posterior instability who completed the full course of treatment and provided pre-and post-treatment patient-reported outcome measures were included in the study. The frequency of shoulder instability was compared by direction, mechanism of injury (MOI), and treatment choice through c 2 analyses. A repeated measures analysis of variance was used to compare the functional outcomes by treatment type and direction of instability (a ¼ 0.05). Results: Athletes diagnosed with anterior instability were more likely to report a chief complaint of instability (70%), whereas those diagnosed with posterior instability reported a primary complaint of pain interfering with function (96%) (P ¼ .001). The primary MOI classified as a contact event was similar between anterior and posterior instability groups (77% vs. 54%, P ¼ .06) as well as the decision to proceed with surgery (60% vs. 72%, P ¼ .31). In patients with nonoperative care, athletes with anterior instability had significantly more initial disability than those with posterior instability (32AE6.1 vs. 58AE8.1, P ¼ .001). Pre-and post-treatment Penn Shoulder Scores for athletes treated with early surgery were similar (P > .05). There were no differences in functional outcomes at discharge in those treated nonoperatively regardless of direction of instability (P ¼ .24); however, change in Penn score was significantly greater in those with anterior (61AE18.7) than those with posterior (27 AE 25.2) instability (P ¼ .002). Conclusion:Athletes with anterior instability appear to have different mechanisms and complaints than those with posterior instability. Among those that receive nonoperative treatment, athletes with anterior instability have significantly greater initial disability and change in disability than those with posterior disability during course of care.Institutional review board approval for this project was received from Prisma Health (no. Pro00054926).

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Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study

Cited by 23 publications

References 27 publications

Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study

Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study

Ultrasound Assessment of Anterior Humeral Head Translation in Patients With Anterior Shoulder Instability: Correlation With Demographic, Radiographic, and Clinical Data

Athletes diagnosed with anterior and posterior shoulder instability display different chief complaints and disability

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