Arthroscopic Anterior Shoulder Stabilization of Collision and Contact Athletes

• Published in: The American journal of sports medicine 2005-01, Vol.33 (1), p.52-60
• Main Authors: Mazzocca, Augustus D., Brown, Fred M., Carreira, Dominic S., Hayden, Jennifer, Romeo, Anthony A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arthroscopy; Arthroscopy - methods; Athletes; Athletic Injuries - surgery; Biological and medical sciences; Care and treatment; Cohort Studies; Endoscopic surgery; Fundamental and applied biological sciences. Psychology; High school football; Humans; Joint Instability - etiology; Joint Instability - surgery; Joints; Ligaments; Male; Medical sciences; Patient outcomes; Recurrence; Retrospective Studies; Secondary schools; Shoulder; Shoulder Dislocation - surgery; Sport (general aspects); Sports medicine; Suture Techniques; Traumas. Diseases due to physical agents; Treatment Outcome; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546504268037

Background: Repair of the anterior labrum (Bankart lesion) with tightening of the ligaments (capsulorrhaphy) is the recommended treatment for recurrent anterior glenohumeral dislocations. Current evidence suggests that arthroscopic anterior stabilization methods yield similar failure rates for resubluxation and redislocation when compared to open techniques. Study Design: Case series; Level of evidence, 4 Purpose: To examine the results of arthroscopic anterior shoulder stabilization of high-demand collision and contact athletes. Methods: Thirteen collision and 5 contact athletes were identified from the senior surgeon’s case registry. Analysis was limited to patients younger than 20 years who were involved in collision (football) or contact (wrestling, soccer) athletics. Objective testing included preoperative and postoperative range of motion and stability. Outcome measures included the American Shoulder and Elbow Society shoulder score, Simple Shoulder Test, SF-36, and Rowe scores. The surgical procedure was performed in a consistent manner: suture anchor repair of the displaced labrum, capsulorrhaphy with suture placement supplemented with thermal treatment of the capsule when indicated, and occasional rotator interval closure. Average follow-up was 37 months (range, 24–66 months). Results: Two of 18 contact and collision athletes (11%) experienced recurrent dislocations after the procedure; both were collision athletes. One returned to play 3 years of high school football but failed after diving into a pool. One patient failed in his second season after his stabilization (>2 years) when making a tackle. None of the contact athletes experienced a recurrent dislocation, with all of them returning to high school or college athletics. Conclusions: One hundred percent of all collision and contact athletes returned to organized high school or college sports. Fifteen percent of those collision athletes had a recurrence, which has not required treatment. Participation in collision and contact athletics is not a contraindication for arthroscopic anterior shoulder stabilization using suture anchors, proper suture placement, capsulorrhaphy, and occasional rotator interval plication. Keywords: shoulder instability arthroscopy Bankart athlete