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Return to Play After Shoulder Stabilization

  • Jason J. Shin
  • Bryson LesniakEmail author
Chapter

Abstract

Glenohumeral instability makes up the majority of serious shoulder injuries in football players. These injuries most frequently occur during the competitive season and are especially common in goalkeepers. Young athletes are at an increased risk of recurrent dislocation and may be surgically managed to reduce the rate of instability. Traditional open as well as arthroscopic Bankart repairs have excellent results with excellent rate of return to play. In the presence of significant glenoid bone loss, bone block procedures such as the Latarjet technique have been successfully utilized. Unlike other sport activities which may involve more direct physical contact and overhead activities (rugby, American football), outfield football players can often return to unrestricted play much sooner at 12 weeks. The clinician should consider the pathologic changes, position-specific demands, and the athlete’s motivation when counseling the player about the most appropriate management options.

Top Five Evidence Based References

  1. Arciero RA, Wheeler JH, Ryan JB, McBride JT (1994) Arthroscopic bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med 22:589–594CrossRefPubMedGoogle Scholar
  2. Balg F, Boileau P (2007) The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 89:1470–1477CrossRefPubMedGoogle Scholar
  3. Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ (2004) Nonoperative management for in-season athletes with anterior shoulder instability. Am J Sports Med 32:1430–1433CrossRefPubMedGoogle Scholar
  4. Hart D, Funk L (2015) Serious shoulder injuries in professional soccer: return to participation after surgery. Knee Surg Sports Traumatol Arthrosc 23:2123–2129CrossRefPubMedGoogle Scholar
  5. Hovelius L, Eriksson K, Fredin H, Hagberg G, Hussenius A, Lind B, Thorling J, Weckström J (1983) Recurrences after initial dislocation of the shoulder. Results of a prospective study of treatment. J Bone Joint Surg Am 65:343–349CrossRefPubMedGoogle Scholar

References

  1. 1.
    Usman J, McIntosh AS (2013) Upper limb injury in rugby union football: results of a cohort study. Br J Sports Med 47:374–379CrossRefPubMedGoogle Scholar
  2. 2.
    Matic GT, Sommerfeldt MF, Best TM, Collins CL, Comstock RD, Flanigan DC (2015) Ice hockey injuries among United States high school athletes from 2008/2009-2012/2013. Phys Sportsmed 43:119–125CrossRefPubMedGoogle Scholar
  3. 3.
    Hart D, Funk L (2015) Serious shoulder injuries in professional soccer: return to participation after surgery. Knee Surg Sports Traumatol Arthrosc 23:2123–2129CrossRefPubMedGoogle Scholar
  4. 4.
    Pritchard C, Mills S, Funk L, Batty P (2011) Incidence and management of shoulder injuries in premier league professional football players. Br J Sports Med 45:A15–A15CrossRefGoogle Scholar
  5. 5.
    Cerciello S, Edwards TB, Walch G (2012) Chronic anterior glenohumeral instability in soccer players: results for a series of 28 shoulders treated with the Latarjet procedure. J Orthop Traumatol Off J Ital Soc. Orthop Traumatol 13:197–202Google Scholar
  6. 6.
    Ward JP, Bradley JP (2013) Decision making in the in-season athlete with shoulder instability. Clin Sports Med 32:685–696CrossRefPubMedGoogle Scholar
  7. 7.
    Donohue MA, Owens BD, Dickens JF (2016) Return to play following anterior shoulder dislocation and stabilization surgery. Clin Sports Med 35:545–561CrossRefPubMedGoogle Scholar
  8. 8.
    Owens BD, Dickens JF, Kilcoyne KG, Rue J-PH (2012) Management of mid-season traumatic anterior shoulder instability in athletes. J Am Acad Orthop Surg 20:518–526CrossRefPubMedGoogle Scholar
  9. 9.
    Rouleau DM, Hebert-Davies J, Robinson CM (2014) Acute traumatic posterior shoulder dislocation. J Am Acad Orthop Surg 22:145–152CrossRefPubMedGoogle Scholar
  10. 10.
    Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, Wright AA (2012) Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med 46:964–978CrossRefPubMedGoogle Scholar
  11. 11.
    Salomonsson B, Heine A v, Dahlborn M, Abbaszadegan H, Ahlström S, Dalén N, Lillkrona U (2010) Bony Bankart is a positive predictive factor after primary shoulder dislocation. Knee Surg Sports Traumatol Arthrosc 18:1425–1431CrossRefPubMedGoogle Scholar
  12. 12.
    Antonio GE, Griffith JF, Yu AB, Yung PSH, Chan KM, Ahuja AT (2007) First-time shoulder dislocation: high prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging 26:983–991CrossRefPubMedGoogle Scholar
  13. 13.
    Yanke AB, Shin JJ, Pearson I, Bach BR, Romeo AA, Cole BJ, Verma NN (2017) Three-dimensional magnetic resonance imaging quantification of glenoid bone loss is equivalent to 3-dimensional computed tomography quantification: cadaveric study. Arthroscopy 33:709CrossRefPubMedGoogle Scholar
  14. 14.
    Balg F, Boileau P (2007) The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 89:1470–1477CrossRefPubMedGoogle Scholar
  15. 15.
    Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16:677–694CrossRefPubMedGoogle Scholar
  16. 16.
    Itoi E, Sashi R, Minagawa H, Shimizu T, Wakabayashi I, Sato K (2001) Position of immobilization after dislocation of the glenohumeral joint. A study with use of magnetic resonance imaging. J Bone Joint Surg Am 83–A:661–667CrossRefPubMedGoogle Scholar
  17. 17.
    Itoi E, Hatakeyama Y, Sato T, Kido T, Minagawa H, Yamamoto N, Wakabayashi I, Nozaka K (2007) Immobilization in external rotation after shoulder dislocation reduces the risk of recurrence. A randomized controlled trial. J Bone Joint Surg Am 89:2124–2131PubMedGoogle Scholar
  18. 18.
    Whelan DB, Kletke SN, Schemitsch G, Chahal J (2015) Immobilization in external rotation versus internal rotation after primary anterior shoulder dislocation. Am J Sports Med 44:521–532CrossRefPubMedGoogle Scholar
  19. 19.
    Hovelius L, Eriksson K, Fredin H, Hagberg G, Hussenius A, Lind B, Thorling J, Weckström J (1983) Recurrences after initial dislocation of the shoulder. Results of a prospective study of treatment. J Bone Joint Surg Am 65:343–349CrossRefPubMedGoogle Scholar
  20. 20.
    Paterson WH, Throckmorton TW, Koester M, Azar FM, Kuhn JE (2010) Position and duration of immobilization after primary anterior shoulder dislocation: a systematic review and meta-analysis of the literature. J Bone Joint Surg Am 92:2924–2933CrossRefPubMedGoogle Scholar
  21. 21.
    Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ (2004) Nonoperative Management for In-Season Athletes with Anterior Shoulder Instability. Am J Sports Med 32:1430–1433CrossRefPubMedGoogle Scholar
  22. 22.
    Arciero RA, Wheeler JH, Ryan JB, McBride JT (1994) Arthroscopic bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med 22:589–594CrossRefPubMedGoogle Scholar
  23. 23.
    Bottoni CR, Wilckens JH, DeBerardino TM, D’Alleyrand J-CG, Rooney RC, Harpstrite JK, Arciero RA (2002) A prospective, randomized evaluation of arthroscopic stabilization versus nonoperative treatment in patients with acute, traumatic, first-time shoulder dislocations. Am J Sports Med 30:576–580CrossRefPubMedGoogle Scholar
  24. 24.
    Wheeler JH, Ryan JB, Arciero RA, Molinari RN (1989) Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy 5:213–217CrossRefPubMedGoogle Scholar
  25. 25.
    Tjoumakaris FP, Bradley JP (2011) The rationale for an arthroscopic approach to shoulder stabilization. Arthroscopy 27:1422–1433CrossRefPubMedGoogle Scholar
  26. 26.
    Cole BJ, L’Insalata J, Irrgang J, Warner JJ (2000) Comparison of arthroscopic and open anterior shoulder stabilization. A two to six-year follow-up study. J Bone Joint Surg Am 82–A:1108–1114CrossRefPubMedGoogle Scholar
  27. 27.
    Godin J, Sekiya JK (2011) Systematic review of arthroscopic versus open repair for recurrent anterior shoulder dislocations. Sports Health 3:396–404CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Harris JD, Gupta AK, Mall NA, Abrams GD, McCormick FM, Cole BJ, Bach BR, Romeo AA, Verma NN (2013) Long-term outcomes after Bankart shoulder stabilization. Arthroscopy 29:920–933CrossRefPubMedGoogle Scholar

Copyright information

© ESSKA 2018

Authors and Affiliations

  1. 1.Division of Sports MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA

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