Magnetic Resonance Arthrography in Rugby Players Undergoing Shoulder Stabilization for Glenohumeral Instability: Professionals Have Higher Frequencies of More Pathologies

Abstract

Purpose: To quantify the magnetic resonance arthrography (MRA) findings in rugby players during preoperative workup for anterior surgical stabilization for glenohumeral instability. Methods: All patients who underwent glenohumeral instability surgery in our institution between 2008 and 2018 were considered for inclusion. Rugby players were identified using the patient's medical notes, with subsequent identification of all professional players. All rugby player's preoperative MRA findings were recorded and analyzed. Results: Overall, 267 rugby players were included, 261 of whom were male (97.8%), with a mean age of 22.7 years (range 13-55 years). There were 58 professional rugby players (21.7%). The mean number of pathologies in nonprofessional rugby players was 5.0 pathologies versus 6.2 pathologies in the professional rugby players, with a significant difference in nonprofessional rugby players with up to 3 pathologies versus professional rugby players (26.3% vs 10.3%, P ¼ .01). Professional rugby players had a statistically significant increased incidence of bicipital tendon lesions (25.9% vs 13.9%, P ¼ .009), acromioclavicular joint degeneration (60.3% vs 42.1%, P ¼ .016), glenohumeral bone loss (87.9% vs 69.9%, P ¼ .006), and degenerative changes (67.2% vs 44.0%, P ¼ .002) on their MRAs. Conclusions: Rugby players undergoing surgical stabilization for glenohumeral instability often have a significant number of pathologies identified on MRA at the time of surgery. Professional rugby players showed concerningly greater frequencies of early degenerative changes when compared with nonprofessional rugby players.

Clinical outcomes of Gaelic Athletic Association athletes after surgical stabilization in the setting of anterior shoulder instability

“…Preoperative decision-making in relation to choice of surgical intervention was made on a patient-by-patient basis, with numerous factors being considered, including (1) magnetic resonance arthrography findings including (a) percentage of glenoid bone loss, as well as (b) concomitant injury to both the humeral head and the glenoid labrum; (2) patient instability status (high- vs. low-performance athletes, or those whom suffer from primary or recurrent instability), and (3) patient preference. 1 , 6 …”

Long-term outcomes of anterior shoulder instability treated with open latarjet procedure – a systematic review of outcomes at a minimum 15-year follow-up

“…[1][2][3][4] Recurrent instability is not without morbidity, with each dislocation episode resulting in increasing glenoid bone loss. 5,6 Although a myriad of management options exist, the open Latarjet (OL) procedure has emerged as the procedure of choice for many, with recent consensus guidelines recommending its use in cases of recurrent shoulder instability in patients with >15% glenoid bone loss. [7][8][9][10][11] The OL procedure has previously been reported to result in excellent clinical outcomes in the short term, with high rates of return to play (RTP) and low recurrence rates at medium-term follow-up, 10,[12][13][14][15][16][17] with the procedure being increasingly performed using an arthroscopic technique.…”

“…1–4 Recurrent instability is not without morbidity, with each dislocation episode resulting in increasing glenoid bone loss. 5,6 Although a myriad of management options exist, the open Latarjet (OL) procedure has emerged as the procedure of choice for many, with recent consensus guidelines recommending its use in cases of recurrent shoulder instability in patients with >15% glenoid bone loss. 7–11…”

Clinical Outcomes in Patients With Humeral Avulsion Glenohumeral Ligament Lesions in the Setting of Anterior Shoulder Instability: A Retrospective Comparative Study

“…8 The complexity of the anatomic shoulder stabilizers results in a variety of pathologies in patients with anterior shoulder instability. 3,10,13,14,20,25 Davey et al 5,6 previously reported that the average collision athlete with anterior shoulder instability experiences a multitude of pathologies secondary to recurrent dislocations displayed on preoperative imaging before surgical stabilization, with bony Bankart and Hill-Sachs lesions being the most common. In addition, the humeral avulsion glenohumeral ligament (HAGL) lesion has been shown to occur in up to 10% of cases of recurrent anterior shoulder instability.…”