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Assessment of return to play in professional overhead athletes subjected to arthroscopic repair of rotator cuff tears and associated labral injuries using the Italian version of the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow score

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Abstract

Background

The self-administered Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow questionnaire is a reliable and sensitive outcome tool to assess upper extremity athletic performance and functional changes affecting return to play in overhead athletes. We report the results of a study of return to sport in professional overhead athletes at a mean follow-up of 2 years after arthroscopic repair of rotator cuff tears and associated labral injuries using the Italian version of the score.

Materials and methods

A total number of 38 patients completed the 10-item questionnaire before and after surgery. They were also asked (1) whether they had returned to play; (2) how many months after the operation they had done so; (3) the level of postoperative performance (preinjury or less); and (4) whether they had had to change sport due to their shoulder problems.

Results

Significant differences were found (1) between preoperative and postoperative scores; (2) between the scores of patients who returned to play at preinjury level and those who merely returned to competition; and (3) between the postoperative subscores of 8/10 items, which were higher in the patients who returned to preinjury performance than in those who merely returned to play; the two items that were not significantly different between these subgroups concerned pain and joint stability. Even though item analysis highlighted a major role for athletic performance in recovery of preinjury performance, it also stressed that the athlete’s relationship with coach, agent, and staff and his/her feeling of the extent to which the arm affects current performance significantly contribute to the final score.

Conclusions

The KJOC Shoulder and Elbow score provides an accurate and exhaustive assessment of the recovery of the athlete’s shoulder in relation to preinjury performance and provides the surgeon with key information on the pros and cons of surgical management.

Keywords

Shoulder Overhead athletes Rotator cuff Labral injuries Arthroscopy Return to sport 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest

References

  1. 1.
    Gainor BJ, Piotrowski G, Puhl J, Allen WC, Hagen R (1980) The throw: biomechanics and acute injury. Am J Sports Med 8:114–118CrossRefPubMedGoogle Scholar
  2. 2.
    Economopoulos KJ, Brockmeier SF (2012) Rotator cuff tears in overhead athletes. Clin Sports Med 31:675–692.  https://doi.org/10.1016/j.csm.2012.07.005 CrossRefPubMedGoogle Scholar
  3. 3.
    McCreesh KM, Purtill H, Donnelly AE, Lewis JS (2017) Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy. BMJ Open Sport Exerc Med 3:e000279.  https://doi.org/10.1136/bmjsem-2017-000279 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Cook JL, Purdam CR (2009) Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 43:409–416.  https://doi.org/10.1136/bjsm.2008.051193 CrossRefPubMedGoogle Scholar
  5. 5.
    Shindle MK, Nho SJ, Nam D, Macgillivray JD, Cordasco FA, Adler RS et al (2011) Technique for margin convergence in rotator cuff repair. HSS J 7:208–212CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Voos JE, Barnthouse CD, Scott AR (2012) Arthroscopic rotator cuff repair: techniques in 2012. Clin Sports Med 31:633–644.  https://doi.org/10.1016/j.csm.2012.07.002 CrossRefPubMedGoogle Scholar
  7. 7.
    Parson B, Olujimi V (2017) The evolution of arthroscopic rotator cuff repair techniques: what repair construct to use and how to do it well. Tech Shoulder Elb Surg 18:1–7CrossRefGoogle Scholar
  8. 8.
    Ostrander RV 3rd, Smith J, Saper M (2016) Triple-row modification of the suture-bridge technique for arthroscopic rotator cuff repair. Arthrosc Tech 5(5):e1007–e1013CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    van der Meijden OA, Westgard P, Chandler Z, Gaskill TR, Kokmeyer D, Millett PJ (2012) Rehabilitation after arthroscopic rotator cuff repair: current concept review and evidence-based guidelines. Int J Sports Phys Ther 7:197–218PubMedPubMedCentralGoogle Scholar
  10. 10.
    Vo A, Zhou H, Dumont G, Fogerty S, Rosso C, Li X (2013) Physical therapy and rehabilitation after rotator cuff repair: a review of current concepts. Int J Phys Med Rehabil 1:5.  https://doi.org/10.4172/2329-9096.1000142 Google Scholar
  11. 11.
    Conti M, Garofalo R, Delle Rose G, Massazza G, Vinci E, Randelli M et al (2009) Post-operative rehabilitation after surgical repair of the rotator cuff. Chir Organi Mov 93:S55–S63.  https://doi.org/10.1007/s12306-009-0003-9 PubMedGoogle Scholar
  12. 12.
    Denard PJ, Burkhart SS (2013) The evolution of suture anchors in arthroscopic rotator cuff repair. Arthroscopy 29:1589–1595.  https://doi.org/10.1016/j.arthro.2013.05.011 CrossRefPubMedGoogle Scholar
  13. 13.
    Tashjian RZ, Hoy RW, Helgerson JR, Guss AD, Henninger HB, Burks RT (2018) Biomechanical comparison of transosseous knotless rotator cuff repair versus transosseous equivalent repair: half the anchors with equivalent biomechanics? Arthroscopy 34:58–63.  https://doi.org/10.1016/j.arthro.2017.08.253 CrossRefPubMedGoogle Scholar
  14. 14.
    Klouche S, Lefevre N, Herman S, Gerometta A, Bohu Y (2016) Return to sport after rotator cuff tear repair: a systematic review and meta-analysis. Am J Sports Med 44:1877–1887.  https://doi.org/10.1177/0363546515598995 CrossRefPubMedGoogle Scholar
  15. 15.
    Alberta FG, ElAttrache NS, Bissell S, Moh K, Browdy J, Yocum L, Jobe F (2010) The development and validation of a functional assessment tool for the upper extremity in the overhead athlete. Am J Sports Med 38:903–911.  https://doi.org/10.1177/0363546509355642 CrossRefPubMedGoogle Scholar
  16. 16.
    Domb BG, Davis JT, Alberta FG et al (2010) Clinical follow-up of professional baseball players undergoing ulnar collateral ligament reconstruction using the new Kerlan-Jobe orthopaedic clinic overhead athlete shoulder and elbow score (KJOC score). Am J Sports Med 38:1558–1563.  https://doi.org/10.1177/0363546509359060 CrossRefPubMedGoogle Scholar
  17. 17.
    Neri BR, ElAttrache NS, Owsley KC, Mohr K, Yocum LA (2011) Outcome of type II superior labral anterior posterior repairs in elite overhead athletes: effect of concomitant partial thickness rotator cuff tears. Am J Sports Med 39:114–120.  https://doi.org/10.1177/0363546510379971 CrossRefPubMedGoogle Scholar
  18. 18.
    Neuman BJ, Boisvert CB, Reiter B, Lawson K, Ciccotti MG, Cohen SB (2011) Results of arthroscopic repair of type II superior labral anterior posterior lesions in overhead athletes: assessment of return to preinjury playing level and satisfaction. Am J Sports Med 39:1883–1888.  https://doi.org/10.1177/0363546511412317 CrossRefPubMedGoogle Scholar
  19. 19.
    Merolla G, Corona K, Zanoli G, Cerciello S, Giannotti S, Porcellini G (2017) Cross-cultural adaptation and validation of the Italian version of the Kerlan-Jobe orthopaedic clinic shoulder and elbow score. J Orthop Traumatol 18:415–421.  https://doi.org/10.1007/s10195-017-0467-6 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279CrossRefPubMedGoogle Scholar
  21. 21.
    Walch G, Boileau P, Noel E, Donell ST (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1(5):238–245.  https://doi.org/10.1016/S1058-2746(09)80065-7 CrossRefPubMedGoogle Scholar
  22. 22.
    Burkhart SS, Morgan CD (1998) The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy 14:637–640CrossRefPubMedGoogle Scholar
  23. 23.
    Young SW, Dakic J, Stroia K, Nguyen ML, Safran MR (2017) Arthroscopic shoulder surgery in female professional tennis players: ability and timing to return to play. Clin J Sport Med 27:357–360.  https://doi.org/10.1097/JSM.0000000000000361 CrossRefPubMedGoogle Scholar
  24. 24.
    Beyzadeoglu T, Circi E (2015) Superior labrum anterior posterior lesions and associated injuries: return to play in elite athletes. Orthop J Sports Med.  https://doi.org/10.1177/2325967115577359 PubMedPubMedCentralGoogle Scholar
  25. 25.
    Antoni M, Klouche S, Mas V, Ferrand M, Bauer T, Hardy P (2016) Return to recreational sport and clinical outcomes with at least 2 years follow-up after arthroscopic repair of rotator cuff tears. Orthop Traumatol Surg Res 102:563–567.  https://doi.org/10.1016/j.otsr.2016.02.015 CrossRefPubMedGoogle Scholar
  26. 26.
    Plate JF, Haubruck P, Walters J, Mannava S, Smith BP, Smith TL et al (2013) Rotator cuff injuries in professional and recreational athletes. J Surg Orthop Adv 22:134–142CrossRefPubMedGoogle Scholar
  27. 27.
    Merolla G, De Santis E, Campi F, Paladini P, Porcellini G (2010) Supraspinatus and infraspinatus weakness in overhead athletes with scapular dyskinesis: strength assessment before and after restoration of scapular musculature balance. Musculoskelet Surg 94:119–125.  https://doi.org/10.1007/s12306-010-0082-7 CrossRefPubMedGoogle Scholar

Copyright information

© Istituto Ortopedico Rizzoli 2018

Authors and Affiliations

  1. 1.Shoulder and Elbow Unit“D. Cervesi” Hospital, AUSL della Romagna Ambito RiminiCattolicaItaly
  2. 2.Biomechanics Laboratory“D. Cervesi” HospitalCattolicaItaly
  3. 3.Orthopaedic and Trauma UnitPoliclinico di Modena, University of Modena and Reggio EmiliaModenaItaly

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