Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport

DeLong, Jeffrey M.; Bradley, James P.

doi:10.5312/wjo.v6.i11.927

Cited by 32 publications

(26 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Results in those series that did examine throwers individually after posterior labral repair revealed a rate of return to play for elite throwers of approximately 30% to 60%. 8 Radkowski et al 28 compared the results of posterior capsular labral repair for posterior instability between throwing and nonthrowing athletes and showed similar results in terms of patient satisfaction. The authors used a variety of surgical techniques and found that throwing athletes were less likely to return to preinjury level sports (55%) as compared with nonthrowing athletes (71%).…”

Section: Discussionmentioning

confidence: 98%

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

et al. 2019

View full text Add to dashboard Cite

Background: There is a paucity of information regarding the treatment of posterior labral tears of the shoulder for baseball players. Reports regarding treatment and postoperative outcomes are more limited than its anterior and superior counterparts. Purpose: To evaluate the clinical presentation, surgical findings, postoperative outcomes, and rate of return to sport after arthroscopic repair of posterior labral injuries of the shoulder among baseball players. Study Design: Case series; Level of evidence, 4. Methods: Retrospective review was performed of baseball players who underwent arthroscopic posterior labral repair between 2009 and 2015 by a single surgeon, with a minimum 2-year follow-up. The group was composed of 32 male patients involved in recreational (6.3%), high school (43.8%), college (31.3%), and professional (18.8%) baseball, with a mean age of 20.5 years. Patients were categorized by chief complaint, clinical findings, surgical findings, and concomitant procedures performed. Pre- and postoperative measures included pain scale, range of motion, American Shoulder and Elbow Surgeons shoulder score, return to play, and patient satisfaction. Results: A variety of tear patterns were identified; 32% involved 90° of the posterior superior labrum; 35% involved the posterior 180°; and 32% involved 90° of the posterior inferior labrum. The dominant mechanism of injury was throwing (34.4%). The most common chief complaint was pain (n = 25, 78%), followed by pain and instability symptoms (n = 6, 18.8%), with only 3% citing isolated sensation of instability. Magnetic resonance imaging clearly identified tear patterns in 75% of cases. American Shoulder and Elbow Surgeons scores significantly improved ( P < .0001), increasing on average 30.9 points from the preoperative mean of 65.4 to a postoperative mean of 96.3. No significant range of motion deficits were noted. Tear size and number of anchors utilized did not influence outcomes. Ninety-four percent of athletes returned to play, 61% at previous levels, and 6% did not return. Pitchers had a lower return to previous level of play than position players (41% vs 86%, P = .0113). Conclusion: Arthroscopic treatment of posterior labral tears of baseball players was effective in improving pain and function, resulting in 94% patient satisfaction and 94% return to sport, with 61% returning to previous level of play. Patient presentation is variable, with a majority of patients citing pain rather than instability.

show abstract

Section: Discussionmentioning

confidence: 98%

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In patients who suffer from higher glenoid retroversion (more than 15°-20°) with intact soft tissue, an open wedge osteotomy may be the treatment of choice. DeLong et al[ 37 ] performed a systematic literature review, stating that posterior glenoid osteotomy does not show any good results in terms of return to pre-injury athletic level[ 22 , 38 ].…”

Section: Shoulder Joint Complex In Posterior Shoulder Dislocationmentioning

confidence: 99%

Biomechanics of posterior shoulder instability - current knowledge and literature review

Bäcker

Galle

Maniglio

et al. 2018

WJO

View full text Add to dashboard Cite

Posterior instability of the shoulder is a rare condition and represents about 10% of shoulder instability. It has become more frequently recognized in the last year, even though it is more difficult to diagnose than anterior shoulder instability. As this form of shoulder pathology is somewhat rare, biomechanical knowledge is limited. The purpose of our study was to perform an extensive literature search, including PubMed and Medline, and to give an overview of the current knowledge on the biomechanics of posterior shoulder instability. The PubMed/Medline databases were utilized, and all articles related to posterior shoulder instability and biomechanics were included to form a comprehensive compilation of current knowledge. A total of 93 articles were deemed relevant according to our inclusion and exclusion criteria. As expected with any newly acknowledged pathology, biomechanical studies on posterior shoulder instability remain limited in the literature. Current biomechanical models are performed in a static manner, which limits their translation for explaining a dynamic pathology. Newer models should incorporate dynamic stabilization of both the rotator cuff and scapulothoracic joint. There is a current lack of knowledge with regards to the pathomechanism of posterior shoulder instability, with no consensus on appropriate treatment regimens. Further investigation is therefore required at both basic science and clinical levels.

show abstract

“…Primary injury mechanisms may include (1) repetitive microtrauma leading to attenuation injuries to the posterior capsule and labrum (most common in the military population); (2) acute, traumatic posterior force resulting in shearing at the chondrolabral junction and subsequent capsulolabral detachment; and (3) insidious onset laxity resulting in stretching of the posterior capsule and passive stabilizers. 10 …”

Section: Pathoanatomymentioning

confidence: 99%

Posterior Shoulder Instability

Antosh

Tokish

Owens

2016

Sports Health: A Multidisciplinary Approach

View full text Add to dashboard Cite

Context:Posterior shoulder instability has become more frequently recognized and treated as a unique subset of shoulder instability, especially in the military. Posterior shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. “Posterior instability” may encompass both dislocation and subluxation, and the most common presentation is recurrent posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of posterior shoulder instability has evolved.Evidence Acquisition:Electronic databases including PubMed and MEDLINE were queried for articles relating to posterior shoulder instability.Study Design:Clinical review.Level of Evidence:Level 4.Results:In low-demand patients, nonoperative treatment of posterior shoulder instability should be considered a first line of treatment and is typically successful. Conservative treatment, however, is commonly unsuccessful in active patients, such as military members. Those patients with persistent shoulder pain, instability, or functional limitations after a trial of conservative treatment may be considered surgical candidates. Arthroscopic posterior shoulder stabilization has demonstrated excellent clinical outcomes, high patient satisfaction, and low complication rates. Advanced techniques may be required in select cases to address bone loss, glenoid dysplasia, or revision.Conclusion:Posterior instability represents about 10% of shoulder instability and has become increasingly recognized and treated in military members. Nonoperative treatment is commonly unsuccessful in active patients, and surgical stabilization can be considered in patients who do not respond. Isolated posterior labral repairs constitute up to 24% of operatively treated labral repairs in a military population. Arthroscopic posterior stabilization is typically considered as first-line surgical treatment, while open techniques may be required in complex or revision settings.

show abstract

Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport

Cited by 32 publications

References 40 publications

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

Biomechanics of posterior shoulder instability - current knowledge and literature review

Posterior Shoulder Instability

Contact Info

Product

Resources

About