Sporting Activity After Arthroscopic Bankart Repair for Chronic Glenohumeral Instability

Plath, Johannes E.; Feucht, Matthias J.; Saier, Tim; Minzlaff, Philipp; Seppel, Gernot; Braun, Sepp

doi:10.1016/j.arthro.2015.04.087

Cited by 23 publications

(31 citation statements)

References 33 publications

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“… 2 , 24 In a study of 58 high school, collegiate, and professional American football players treated with open shoulder stabilization, Pagnani and Dome 24 found that 89.7% were able to return to playing football for at least 1 year. Recently, Plath et al 28 reported on return to sport of athletes across a variety of sports after arthroscopic Bankart repair for chronic glenohumeral instability. All 57 patients were able to return to at least 1 sporting or recreational activity after surgery, with 66% stating that the repair had strongly (33%) improved their sporting and recreational “proficiency” compared with preoperatively.…”

Section: Return To Play After Surgerymentioning

confidence: 99%

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A Clinical Review of Return-to-Play Considerations After Anterior Shoulder Dislocation

Watson

Allen

Grant

2016

Sports Health: A Multidisciplinary Approach

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Context:Shoulder dislocations are common in contact sports, yet guidelines regarding the best treatment strategy and time to return to play have not been clearly defined.Evidence Acquisition:Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1980 through 2015.Study Design:Clinical review.Level of Evidence:Level 4.Results:Much has been published about return to play after anterior shoulder dislocation, but almost all is derived from expert opinion and clinical experience rather than from well-designed studies. Recommendations vary and differ depending on age, sex, type of sport, position of the athlete, time in the sport’s season, and associated pathology. Despite a lack of consensus and specific recommendations, there is agreement that before being allowed to return to sport, athletes should be pain free and demonstrate symmetric shoulder and bilateral scapular strength, with functional range of motion that allows sport-specific participation. Return to play usually occurs 2 to 3 weeks from the time of injury. Athletes with in-season shoulder instability returning to sport have demonstrated recurrence rates ranging from 37% to 90%. Increased bone loss, recurrent instability, and injury occurring near the end of season are all indications that may push surgeons and athletes toward earlier surgical intervention.Conclusion:Most athletes are able to return to play within 2 to 3 weeks but there is a high risk of recurrent instability.

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Section: Return To Play After Surgerymentioning

confidence: 99%

“…All 57 patients were able to return to at least 1 sporting or recreational activity after surgery, with 66% stating that the repair had strongly (33%) improved their sporting and recreational “proficiency” compared with preoperatively. 28 …”

Section: Return To Play After Surgerymentioning

confidence: 99%

A Clinical Review of Return-to-Play Considerations After Anterior Shoulder Dislocation

Watson

Allen

Grant

2016

Sports Health: A Multidisciplinary Approach

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“…One-third of patients who underwent arthroscopic Bankart repair for chronic glenohumeral instability reported no benefit from surgery in terms of sporting activity. 9 Improvement in sporting proficiency was negatively correlated with preoperative activity and performance but positively correlated with age. Overall, while a significant number of patients did get back to activity after surgery, there was no benefit in duration, frequency, or performance level and no increased return to high-level activities.…”

Section: Discussionmentioning

confidence: 95%

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls

Brophy

Hettrich

Ortiz

et al. 2016

Sports Health: A Multidisciplinary Approach

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Background:Shoulder activity level may be a risk factor for shoulder instability, an indication for surgical intervention, and a risk factor for failure of operative stabilization.Hypothesis:Patients undergoing shoulder stabilization surgery have a higher activity level compared with sex- and age-matched healthy controls.Study Design:Cross-sectional study.Level of Evidence:Level 2.Methods:Patients undergoing shoulder stabilization surgery aged 18 to 50 years were prospectively enrolled. As part of data collection, patients completed a previously validated shoulder activity scale, which generates a score reporting frequency of activity ranging from 0 (least active) to 20 (most active). The activity level of these patients was compared with sex- and age-matched norms for a healthy population with no history of shoulder disorders.Results:A total of 409 subjects (343 male, 66 female) undergoing shoulder instability surgery completed the activity scale. Seventy-seven percent of patients had higher shoulder activity level than sex- and age-matched controls. Seventy-nine percent aged 18 to 30 years had a higher shoulder activity level than controls, with an identical distribution for men (79%) and women (79%). Among patients aged 31 to 50 years, 70% had higher activity than controls. However, men were more likely to have a higher activity level than controls (72%) versus women (59%). In patients aged 18 to 30 years, median activity level for instability patients was 14 in men compared with 10 in controls, and 13 in women compared with 8 in controls. In patients aged 31 to 50 years, median activity level was 13 in men compared with 10 in controls and 10 in women compared with 8 in controls.Conclusion:Patients undergoing shoulder stabilization surgery have a higher activity level than sex- and age-matched healthy controls.Clinical Relevance:Shoulder activity is especially elevated in younger, male instability patients.

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“…When we address young patients with anterior glenohumeral instability, the recurrence rate is high and the surgical treatment is, in most cases, the best option. In the majority of operated patients, the return to active professional life, sports and others without apprehension is the rule [ 44 - 47 ]. So we believe that surgery will produce good outcomes and the result is largely positive.…”

Section: Will Surgical Treatment Prevent Degenerative Joint Disease Amentioning

confidence: 99%

Natural History of Anterior Shoulder Instability

Carpinteiro

Barros

2017

TOORTHJ

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Background:The shoulder is the most complex joint in the body. The large freedom of motion in this joint is the main cause of instability. Instability varies in its degree, direction, etiology and volition and there is a large spectrum of conditions. Methods:Based on literature research and also in our own experience, we propose to elucidate the reader about the natural history of instability and its importance for the appropriate management of this pathology, by answering the following questions:What happens in the shoulder after the first dislocation? Which structures suffer damage? Who are the patients at higher risk of recurrence? How does the disease evolve without treatment? Will surgical treatment avoid future negative outcomes and prevent degenerative joint disease? Who should we treat and when?Results:80% of anterior-inferior dislocations occur in young patients. Recurrent instability is common and multiple dislocations are the rule. Instability is influenced by a large number of variables, including age of onset, activity profile, number of episodes,delay between first episode and surgical treatment.Conclusion:Understanding the disease and its natural evolution is determinant to decide the treatment in order to obtain the best outcome. It is crucial to identify the risk factors for recurrence. Delay in surgical treatment, when indicated, leads to worse results. Surgical technique should address the type and severity of both soft tissue and bone lesions, when present.

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Sporting Activity After Arthroscopic Bankart Repair for Chronic Glenohumeral Instability

Cited by 23 publications

References 33 publications

A Clinical Review of Return-to-Play Considerations After Anterior Shoulder Dislocation

A Clinical Review of Return-to-Play Considerations After Anterior Shoulder Dislocation

Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls

Natural History of Anterior Shoulder Instability

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