Shoulder apprehension

Lädermann, Alexandre; Tirefort, Jérôme; Zanchi, Davide; Haller, Sven; Charbonnier, Caecilia; Hoffmeyer, Pierre; Cunningham, Grégory

doi:10.1302/2058-5241.3.180007

Cited by 19 publications

(10 citation statements)

References 55 publications

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“…For a positive apprehension sign, we suggest using the definition as mentioned by Lädermann et al. 100 as fear of imminent dislocation when placing the arm in abduction and external rotation during physical examination. We suggest not using the definition recurrence of instability anymore to avoid using multiple meanings of this term; if used we suggest using the definition as a dislocation or a subluxation and also report on these events separately.…”

Section: Discussionmentioning

confidence: 99%

High Variability of the Definition of Recurrent Glenohumeral Instability: An Analysis of the Current Literature by a Systematic Review

Alkaduhimi¹,

Connelly

Deurzen³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To determine the definitions for recurrence used in the literature, assess the consensus in using these definitions, and determine the impact of these definitions on recurrence rates. Methods: A literature search was performed in PubMed and EMBASE including studies from 2000 to 2020 reporting on recurrence rates after anterior arthroscopic shoulder instability surgery. Dislocation, apprehension, subluxation and recurrence rates were compared. Results: Ninety-one studies were included. In 68% of the eligible studies, recurrence rates are not well defined. Thirty (33%) studies did not report on dislocations, 45 (49%) did not report on subluxations, and 58 (64%) did not report on apprehension. Seventeen different definitions for recurrence of instability, 4 definitions of dislocations, and 8 definitions of subluxation were used. Conclusion: Recurrence rates are poorly specified and likely underreported in the literature, hampering comparison with results of other studies. This highlights the need for a consensus on definition of recurrence across shoulder instability studies. We recommend not using the definition recurrence of instability anymore. We endorse defining dislocations as a radiographically confirmed dislocation or a dislocation that is manually reduced, subluxations as the feeling of a dislocation that can be (spontaneously) reduced without the need for a radiographically confirmed dislocation, and a positive apprehension sign as fear of imminent dislocation when placing the arm in abduction and external rotation during physical examination. Reporting on the events resulting in a dislocation or subluxation aids in making an estimation of the severity of instability. Level of Evidence: Level IV, systematic review.

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Section: Discussionmentioning

confidence: 99%

High Variability of the Definition of Recurrent Glenohumeral Instability: An Analysis of the Current Literature by a Systematic Review

Alkaduhimi¹,

Connelly

Deurzen³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…However, a positive apprehension test in 17% of patients proved that this is more complex than a simple mechanical consequence and may involve central neurological impairment. 21 Resuming rugby at the preinjury level as soon as possible is an integral part of a successful result after surgical treatment of shoulder instability. In our series, we noted no significant difference in return to the same level of play between the LT and BK groups.…”

Section: Discussionmentioning

confidence: 99%

Outcomes at Long-term Follow-up After Open Latarjet Versus Open Bankart Repair in Rugby Players

Bonnevialle

Mattési

Martinel³

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Because rugby is a collision sport, it exposes players to a high risk of recurrence after anterior shoulder stabilization. Therefore, the choice of surgical procedure warrants close attention in order to optimize the time to return to sport and the stability of the shoulder throughout the player’s career. Hypothesis: The open Latarjet procedure would allow for a faster return to play and provide a lower rate of recurrence than the open Bankart repair at long-term follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: The study retrospectively enrolled 62 competitive rugby players who had undergone an anterior shoulder instability procedure and had at least 5 years of follow-up data. A total of 32 players treated with an open Bankart repair (BK group) were compared with 30 players (31 shoulders) treated with an open Latarjet procedure (LT group). Outcomes between groups were compared with the Rowe score, Walch-Duplay score, recurrence rate, and osteoarthritis evaluation on plain radiograph (Samilson classification). Results: The recurrence rate was significantly higher at 18.8% for the BK group (mean follow-up, 6.9 ± 1.7 years) compared with 3.3% for the LT group (mean follow-up, 6.2 ± 1.4 years) ( P = .04). No postoperative complications occurred in the BK group, whereas 1 infection and 1 hematoma required a second surgery in the LT group ( P = .14). In the BK and LT groups, 97% and 90% of players, respectively, were able to return to rugby at the same level or higher ( P = .27), at a mean time of 8 and 6.3 months, respectively ( P = .03). The mean Rowe and Walch-Duplay scores were not significantly different between the groups; however, the osteoarthritis rate was significantly higher in the BK versus the LT group (68% vs 38%, respectively; P = .03); 23% of patients, all in the BK group, had Samilson grade 2 osteoarthritis. Conclusion: The open Latarjet procedure outperformed the open Bankart procedure in terms of stability, time to return to play, and radiological outcomes at long-term follow-up in competitive rugby players.

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“…Apprehension was defined as fear of imminent dislocation during sports activities and evaluated in four degrees according to the frequency of subjective apprehension in sports activities in the postoperative period: 1: always, 2: often, 3: sometimes, 4: never [19]. Patients were also evaluated according to the degree of 'return to sports at pre-injury level' at the last follow-up, rated as 1: severe restriction (< 25%), 2: return with moderate restraint (25-50%) 3: mild.…”

Section: Outcome Measuresmentioning

confidence: 99%

Remplissage reduced sense of apprehension and increased the rate of return to sports at preinjury level of elite overhead athletes with on‐track anterior shoulder instability

Kirac,

Ergun,

Gamli

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose The purpose of this study was to compare the results of arthroscopic isolated Bankart repair (B) with Bankart repair plus Remplissage (B + R) procedure in contact overhead athletes with on-track anterior shoulder instability. Methods A total of 64 athletes playing basketball, volleyball and handball in elite professional level who underwent arthroscopic isolated Bankart repair (34 patients) or Bankart repair plus Remplissage procedure (30 patients) with the diagnosis of recurrent anterior shoulder instability between 2017 and 2020, were retrospectively reviewed. Radiologically all patients had on-track Hill-Sachs defects and minimal or subcritical glenoid bone loss (< 13.5%). Patients were evaluated using preand postoperative pVAS, SANE, ASES, ROWE, WOSI scores and postoperative active ROM assessment. Patients were also asked for the frequency of any subjective apprehension and satisfaction with the surgery in four grades. ResultsThe mean ages of the groups B and B + R were 26.8 and 26 years (SD = 3.22), respectively; the mean follow-up times were 37.8 and 36.2 months (SD = 11.19). Compared with the preoperative status, there was a statistically significant improvement of all 5 postoperative outcome scores in both groups (P < 0.001). However, significant difference between the improvement of the groups were only found for the SANE (

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Shoulder apprehension

Cited by 19 publications

References 55 publications

High Variability of the Definition of Recurrent Glenohumeral Instability: An Analysis of the Current Literature by a Systematic Review

High Variability of the Definition of Recurrent Glenohumeral Instability: An Analysis of the Current Literature by a Systematic Review

Outcomes at Long-term Follow-up After Open Latarjet Versus Open Bankart Repair in Rugby Players

Remplissage reduced sense of apprehension and increased the rate of return to sports at preinjury level of elite overhead athletes with on‐track anterior shoulder instability

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