Clinical Characteristics and Surgical Outcomes for Collision Athletes with Traumatic Posterior Instability
Background: Diagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes. Methods: The author surgically treated patients with a diagnos...
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| Published in | Journal of Nippon Medical School Vol. 88; no. 2; pp. 133 - 137 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The Medical Association of Nippon Medical School
24.04.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-4676 1347-3409 1347-3409 |
| DOI | 10.1272/jnms.JNMS.2020_88-207 |
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| Abstract | Background: Diagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes. Methods: The author surgically treated patients with a diagnosis of traumatic shoulder joint instability and investigated those that had been followed up for >2 years after surgery. Results: Seven shoulders in six collision athletes with a history of traumatic injury were examined. All cases were negative for the general laxity sign and positive for the posterior jerk test; five shoulders showed positive anterior apprehension. Posterior glenoid osseous defects were found in three shoulders, and one shoulder injury involved anterior and posterior osseous lesions. As surgical treatment, one posterior capsulolabral lesion, two posterior osseous lesions, and three combined anterior and posterior capsulolabral lesions were repaired arthroscopically. In a patient with a combined anterior and posterior osseous lesion, the Bristow procedure was perfromed after arthroscopic osseous repair. Patients returned to competition at an average of 6.8 months after surgery. One patient developed anterior subluxation at 7 months, and another exhibited posterior re-dislocation at 8 months after returning to competition. Conclusion: Traumatic posterior instability in collision athletes often involves glenoid osseous lesions and is frequently accompanied by anterior apprehension and lesions. Although collision athletes can return to play after arthroscopic repair, such activity is associated with a risk of re-dislocation. |
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| AbstractList | Background: Diagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes. Methods: The author surgically treated patients with a diagnosis of traumatic shoulder joint instability and investigated those that had been followed up for >2 years after surgery. Results: Seven shoulders in six collision athletes with a history of traumatic injury were examined. All cases were negative for the general laxity sign and positive for the posterior jerk test; five shoulders showed positive anterior apprehension. Posterior glenoid osseous defects were found in three shoulders, and one shoulder injury involved anterior and posterior osseous lesions. As surgical treatment, one posterior capsulolabral lesion, two posterior osseous lesions, and three combined anterior and posterior capsulolabral lesions were repaired arthroscopically. In a patient with a combined anterior and posterior osseous lesion, the Bristow procedure was perfromed after arthroscopic osseous repair. Patients returned to competition at an average of 6.8 months after surgery. One patient developed anterior subluxation at 7 months, and another exhibited posterior re-dislocation at 8 months after returning to competition. Conclusion: Traumatic posterior instability in collision athletes often involves glenoid osseous lesions and is frequently accompanied by anterior apprehension and lesions. Although collision athletes can return to play after arthroscopic repair, such activity is associated with a risk of re-dislocation. Diagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes.BACKGROUNDDiagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes.The author surgically treated patients with a diagnosis of traumatic shoulder joint instability and investigated those that had been followed up for >2 years after surgery.METHODSThe author surgically treated patients with a diagnosis of traumatic shoulder joint instability and investigated those that had been followed up for >2 years after surgery.Seven shoulders in six collision athletes with a history of traumatic injury were examined. All cases were negative for the general laxity sign and positive for the posterior jerk test; five shoulders showed positive anterior apprehension. Posterior glenoid osseous defects were found in three shoulders, and one shoulder injury involved anterior and posterior osseous lesions. As surgical treatment, one posterior capsulolabral lesion, two posterior osseous lesions, and three combined anterior and posterior capsulolabral lesions were repaired arthroscopically. In a patient with a combined anterior and posterior osseous lesion, the Bristow procedure was perfromed after arthroscopic osseous repair. Patients returned to competition at an average of 6.8 months after surgery. One patient developed anterior subluxation at 7 months, and another exhibited posterior re-dislocation at 8 months after returning to competition.RESULTSSeven shoulders in six collision athletes with a history of traumatic injury were examined. All cases were negative for the general laxity sign and positive for the posterior jerk test; five shoulders showed positive anterior apprehension. Posterior glenoid osseous defects were found in three shoulders, and one shoulder injury involved anterior and posterior osseous lesions. As surgical treatment, one posterior capsulolabral lesion, two posterior osseous lesions, and three combined anterior and posterior capsulolabral lesions were repaired arthroscopically. In a patient with a combined anterior and posterior osseous lesion, the Bristow procedure was perfromed after arthroscopic osseous repair. Patients returned to competition at an average of 6.8 months after surgery. One patient developed anterior subluxation at 7 months, and another exhibited posterior re-dislocation at 8 months after returning to competition.Traumatic posterior instability in collision athletes often involves glenoid osseous lesions and is frequently accompanied by anterior apprehension and lesions. Although collision athletes can return to play after arthroscopic repair, such activity is associated with a risk of re-dislocation.CONCLUSIONTraumatic posterior instability in collision athletes often involves glenoid osseous lesions and is frequently accompanied by anterior apprehension and lesions. Although collision athletes can return to play after arthroscopic repair, such activity is associated with a risk of re-dislocation. Diagnosis and treatment of traumatic posterior instability of the shoulder have not been described in detail. The author investigated surgical outcomes for traumatic posterior shoulder joint instability in collision athletes. The author surgically treated patients with a diagnosis of traumatic shoulder joint instability and investigated those that had been followed up for >2 years after surgery. Seven shoulders in six collision athletes with a history of traumatic injury were examined. All cases were negative for the general laxity sign and positive for the posterior jerk test; five shoulders showed positive anterior apprehension. Posterior glenoid osseous defects were found in three shoulders, and one shoulder injury involved anterior and posterior osseous lesions. As surgical treatment, one posterior capsulolabral lesion, two posterior osseous lesions, and three combined anterior and posterior capsulolabral lesions were repaired arthroscopically. In a patient with a combined anterior and posterior osseous lesion, the Bristow procedure was perfromed after arthroscopic osseous repair. Patients returned to competition at an average of 6.8 months after surgery. One patient developed anterior subluxation at 7 months, and another exhibited posterior re-dislocation at 8 months after returning to competition. Traumatic posterior instability in collision athletes often involves glenoid osseous lesions and is frequently accompanied by anterior apprehension and lesions. Although collision athletes can return to play after arthroscopic repair, such activity is associated with a risk of re-dislocation. |
| Author | Tasaki, Atsushi |
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| References | 1. Robinson CM, Aderinto J. Recurrent posterior shoulder instability. J Bone Joint Surg Am. 2005;87 (4):883-92. 9. Kim SH, Ha KI, Park JH, et al. Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. J Bone Joint Surg Am. 2003;85 (8):1479-87. 6. Kitayama S, Sugaya H, Takahashi N, et al. Clinical outcome and glenoid morphology after arthroscopic repair of chronic osseous bankart lesions: A five to eight-year follow-up study. J Bone Joint Surg Am. 2015;97 (22):1833-43. 3. Buess E, Waibl B, Sieverding M, Halbgewachs J. Posteroinferior shoulder instability: clinical outcome of arthroscopic stabilization in 32 shoulders and categorization based on labral mapping. Arch Orthop Trauma Surg. 2015;135 (5):673-81. 5. Hasegawa Y, Kawasaki T, Nojiri S, et al. The number of injury events associated with the critical size of bipolar bone defects in rugby players with traumatic anterior shoulder instability. Am J Sports Med. 2019;47 (12):2803-8. 7. Tasaki A, Morita W, Yamakawa A, et al. Combined arthroscopic bankart repair and coracoid process transfer to anterior glenoid for shoulder dislocation in rugby players: Evaluation based on ability to perform sport-specific movements effectively. Arthroscopy. 2015;31 (9):1693-701. 13. McFarland EG, Kim TK, Park HB, Neira CA, Gutierrez MI. The effect of variation in definition on the diagnosis of multidirectional instability of the shoulder. J Bone Joint Surg Am. 2003;85 (11):2138-44. 12. Neer CS 2nd, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980;62 (6):897-908. 14. Mazzocca AD, Brown FM Jr, Carreira DS, Hayden J, Romeo AA. Arthroscopic anterior shoulder stabilization of collision and contact athletes. Am J Sports Med. 2005;33 (1):52-60. 4. Altchek DW, Warren RF, Skyhar MJ, Ortiz G. T-plasty modification of the Bankart procedure for multidirectional instability of the anterior and inferior types. J Bone Joint Surg Am. 1991;73 (1):105-12. 8. Katthagen JC, Tahal DS, Montgomery SR, Horan MP, Millett PJ. Association of traumatic and atraumatic posterior shoulder instability with glenoid retroversion and outcomes after arthroscopic capsulolabral repair. Arthroscopy. 2017;33 (2):284-90. 11. Beighton P, Horan F. Orthopaedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg Br. 1969;51 (3):444-53. 2. Provencher MT, LeClere LE, King S, et al. Posterior instability of the shoulder: diagnosis and management. Am J Sports Med. 2011;39 (4):874-86. 10. Dawson J, Fitzpatrick R, Carr A. The assessment of shoulder instability. The development and validation of a questionnaire. J Bone Joint Surg Br. 1999;81 (3):420-6. 15. Javed S, Gheorghiu D, Torrance E, Monga P, Funk L, Walton M. The incidence of traumatic posterior and combined labral tears in patients undergoing arthroscopic shoulder stabilization. Am J Sports Med. 2019;47 (11):2686-90. 11 12 13 14 15 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 1. Robinson CM, Aderinto J. Recurrent posterior shoulder instability. J Bone Joint Surg Am. 2005;87 (4):883-92. – reference: 3. Buess E, Waibl B, Sieverding M, Halbgewachs J. Posteroinferior shoulder instability: clinical outcome of arthroscopic stabilization in 32 shoulders and categorization based on labral mapping. Arch Orthop Trauma Surg. 2015;135 (5):673-81. – reference: 11. Beighton P, Horan F. Orthopaedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg Br. 1969;51 (3):444-53. – reference: 10. Dawson J, Fitzpatrick R, Carr A. The assessment of shoulder instability. The development and validation of a questionnaire. J Bone Joint Surg Br. 1999;81 (3):420-6. – reference: 9. Kim SH, Ha KI, Park JH, et al. Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. J Bone Joint Surg Am. 2003;85 (8):1479-87. – reference: 2. Provencher MT, LeClere LE, King S, et al. Posterior instability of the shoulder: diagnosis and management. Am J Sports Med. 2011;39 (4):874-86. – reference: 8. Katthagen JC, Tahal DS, Montgomery SR, Horan MP, Millett PJ. Association of traumatic and atraumatic posterior shoulder instability with glenoid retroversion and outcomes after arthroscopic capsulolabral repair. Arthroscopy. 2017;33 (2):284-90. – reference: 15. Javed S, Gheorghiu D, Torrance E, Monga P, Funk L, Walton M. The incidence of traumatic posterior and combined labral tears in patients undergoing arthroscopic shoulder stabilization. Am J Sports Med. 2019;47 (11):2686-90. – reference: 13. McFarland EG, Kim TK, Park HB, Neira CA, Gutierrez MI. The effect of variation in definition on the diagnosis of multidirectional instability of the shoulder. J Bone Joint Surg Am. 2003;85 (11):2138-44. – reference: 12. Neer CS 2nd, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980;62 (6):897-908. – reference: 6. Kitayama S, Sugaya H, Takahashi N, et al. Clinical outcome and glenoid morphology after arthroscopic repair of chronic osseous bankart lesions: A five to eight-year follow-up study. J Bone Joint Surg Am. 2015;97 (22):1833-43. – reference: 14. Mazzocca AD, Brown FM Jr, Carreira DS, Hayden J, Romeo AA. Arthroscopic anterior shoulder stabilization of collision and contact athletes. Am J Sports Med. 2005;33 (1):52-60. – reference: 5. Hasegawa Y, Kawasaki T, Nojiri S, et al. The number of injury events associated with the critical size of bipolar bone defects in rugby players with traumatic anterior shoulder instability. Am J Sports Med. 2019;47 (12):2803-8. – reference: 7. Tasaki A, Morita W, Yamakawa A, et al. Combined arthroscopic bankart repair and coracoid process transfer to anterior glenoid for shoulder dislocation in rugby players: Evaluation based on ability to perform sport-specific movements effectively. Arthroscopy. 2015;31 (9):1693-701. – reference: 4. Altchek DW, Warren RF, Skyhar MJ, Ortiz G. T-plasty modification of the Bankart procedure for multidirectional instability of the anterior and inferior types. J Bone Joint Surg Am. 1991;73 (1):105-12. – ident: 7 doi: 10.1016/j.arthro.2015.03.013 – ident: 1 doi: 10.2106/00004623-200504000-00029 – ident: 9 doi: 10.2106/00004623-200308000-00008 – ident: 6 doi: 10.2106/JBJS.N.01033 – ident: 12 doi: 10.2106/00004623-198062060-00004 – ident: 4 doi: 10.2106/00004623-199173010-00013 – ident: 10 doi: 10.1302/0301-620X.81B3.0810420 – ident: 2 doi: 10.1177/0363546510384232 – ident: 3 doi: 10.1007/s00402-015-2193-y – ident: 13 doi: 10.2106/00004623-200311000-00011 – ident: 5 doi: 10.1177/0363546519869673 – ident: 11 doi: 10.1302/0301-620X.51B3.444 – ident: 15 doi: 10.1177/0363546519865910 – ident: 8 doi: 10.1016/j.arthro.2016.07.020 – ident: 14 doi: 10.1177/0363546504268037 |
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| Title | Clinical Characteristics and Surgical Outcomes for Collision Athletes with Traumatic Posterior Instability |
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