Background: The purpose of this study was to compare recurrent instability and return to play (RTP) in young athletes who underwent clearance to full activity based on a validated return-to-sport (RTS) test to those who underwent time-based clearance following primary posterior labral repair.
Methods: This was a retrospective review of athletes with posterior shoulder instability who underwent primary arthroscopic posterior labral repair from 2012 to 2021 with minimum 1-year follow-up. Patients who underwent RTS testing at a minimum of 5 months postoperatively were compared to a historic control cohort of patients who underwent time-based clearance.
Results: There were 30 patients in the RTS cohort and 67 patients in the control cohort (mean follow-up 32.1 and 38.6 months, respectively). Of the 30 patients who underwent RTS testing, 11 passed without failing any sections, 10 passed while failing 1 section, and 9 failed the RTS test by failing 2+ sections. No differences were found between the RTS and control cohort in the incidence of recurrent instability (6.7% vs. 9.0%), overall RTP (94.7% vs. 94.3%), RTP at the same level as before injury (84.2% vs. 80.0%), recurrent pain/weakness (23.3% vs. 25.4%), or revision surgery (0% vs. 3.0%), respectively.
Discussion: While RTS testing in young athletes after posterior labral repair did not reduce recurrence or improve return to play compared to time-based clearance, two-thirds of athletes who underwent testing failed at least 1 section, indicating some functional deficit. Thus, RTS testing may help guide postoperative rehabilitation following posterior stabilization.
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http://dx.doi.org/10.1016/j.jseint.2023.01.002 | DOI Listing |
Am J Sports Med
January 2025
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background: Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions are associated with recurrent shoulder instability and higher rates of failure after capsulolabral repair compared with similarly treated Bankart lesions. Although these lesions can portend poor outcomes, there are limited data on the associated conditions and postoperative course in a young, active population.
Purpose: To evaluate the mid- to long-term clinical course and failure rates after ALPSA repairs and assess features associated with these outcomes.
Arch Bone Jt Surg
January 2024
Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Posterior shoulder instability (PSI) is a shoulder pathology that is challenging to diagnose, leading to treatment delay and exacerbation of symptoms. Etiology can be both traumatic and atraumatic, and a comprehensive clinical history plays a significant role in achieving diagnosis. Imaging in the setting of PSI can reveal a reverse-Bankart lesion, a reverse Hill-Sachs lesion, posterior labral cysts, and potentially glenoid or lesser tuberosity fractures.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Background: Anterior shoulder instability is a common pathology seen especially in young men and highly active patient populations. Subluxation is a commonly encountered clinical issue, yet little is known about the effects of first-time subluxation compared with dislocation on shoulder stability and clinical outcomes after surgical stabilization.
Purpose: To compare revision and redislocation rates as well as patient-reported outcomes (PROs) between subluxators and dislocators after a first-time anterior shoulder instability event.
SICOT J
December 2024
Orthopedic Department, Faculty of Medicine, Ain Shams University, 38 Abbassia, next to the Al-Nour Mosque, 11566 Cairo, Egypt - Orthopedic Surgery, Ain Shams University, 38 Abbassia, next to the Al-Nour Mosque, 11566 Cairo, Egypt.
Introduction: Posterior shoulder dislocation with a reverse Hill-Sachs lesion is a rare and complex injury, requiring specialized treatment due to the difficulty in diagnosis, reduction, and addressing both sides of the pathology to reduce the potential for recurrent dislocation.
Purpose: To evaluate the clinical and functional outcomes of closed reduction and arthroscopic McLaughlin procedure with posterior labral repair in patients with neglected locked posterior shoulder dislocation for less than 12 weeks.
Methods: A prospective study was conducted at university hospitals, managing 15 patients with neglected locked posterior shoulder dislocation for less than 12 weeks and concomitant engaging reverse Hill-Sachs lesions of less than 40% of the humeral articular surface.
J Bodyw Mov Ther
October 2024
Research Department, Abe Osteopathy School, 67027, Raiano, Italy.
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