Young athletes with shoulder instability might benefit from arthroscopy

July 8, 2018, American Orthopaedic Society for Sports Medicine

Young athletes with shoulder instability are considered to be a high-risk group of patients following arthroscopic shoulder stabilization given the high recurrence rates and lower rates of return to sport, which have been reported in the literature. However, according to researchers presenting their work today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in San Diego outcomes may be improved by proper patient selection and reserving arthroscopic stabilization for athletes with fewer incidents of pre-operative instability.

The senior author of this study, Frank A. Cordasco, MD, MS and his colleagues from the Hospital for Special Surgery in New York City presented a series of patients with shoulder between the ages of 14 and 20 who were treated with arthroscopic anterior stabilization performed in the beach chair position by a single surgeon. The primary outcomes were the rates of revision and return to sport at a minimum follow-up of 2 years. Sixty-seven athletes were included in the study with 19 females and 48 males who averaged 17 years of age. There was a low rate of revision surgery of 6% and 82% percent of the athletes returned to sport at an average of 7 months following surgery.

"Our study highlights the importance for with shoulder instability, undergoing a thorough preoperative evaluation to determine the number of instability events and to obtain appropriate advanced imaging when significant bone loss is suspected. Each pre-operative instability episode can result in greater degrees of bone loss, which results in higher failure rates following arthroscopic shoulder stabilization. This pre-operative approach can determine the best procedure to select from the menu of operations we use to manage shoulder instability," said Cordasco. "This menu includes arthroscopic stabilization, open stabilization and bone augmentation such as the Latarjet reconstruction. Providing the young athlete with the appropriate selection from the menu will to lead to the best outcomes in this high-risk group and will allow them to predictably and reproducibly get back in the game.

Forty-two of the 67 (63%) athletes in this study were indicated for surgery after their first dislocation and only a few had more than two instability episodes. "We found a gender-specific difference in that all of the six recurrences occurred in males. This study demonstrates that when the high-risk young with fewer episodes of pre-operative instability is treated with an arthroscopic stabilization, the revision surgery rate is low and the return to sport rate is high. Arthroscopic stabilization may offer the best outcomes in this group when it is performed after the first dislocation. Additional research needs to be performed to continue to improve the outcomes for this challenging group of young, active high-risk athletes," said Cordasco.

Explore further: Researchers determine the rate of return to sport after shoulder surgery

Related Stories

Researchers determine the rate of return to sport after shoulder surgery

July 2, 2018
Athletes with shoulder instability injuries often undergo shoulder stabilization surgery to return to sport (RTS) and perform at their preinjury activity level. Returning to sports in a timely fashion and being able to perform ...

Treatment of shoulder instability helps return collegiate athletes to playing field

July 10, 2015
Athletes who suffer a shoulder instability injury may return to play more successfully after being treated arthroscopically compared to nonoperative treatment, say researchers presenting their work today at the American Orthopaedic ...

High school athletes with shoulder instability benefit from nonoperative treatment

March 10, 2018
Nonoperative treatment of high school athletes with shoulder instability is an effective approach, according to research presented today at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans. ...

Return-to-play rates high for football players after shoulder instability surgery

July 8, 2016
Getting back into the game is important for any athlete after a significant injury but shoulder injuries can be tricky, especially for football players. Researchers presenting their work today at the American Orthopaedic ...

Treating first time shoulder dislocations with surgery can benefit young athletes

July 7, 2016
Shoulder instability is most common in the young, athletic population, bringing a focus to how these injuries are best treated. Research presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual ...

Stabilizing shoulder surgery helps NFL players return to the game

July 10, 2014
Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine's ...

Recommended for you

3-D-printed tracheal splints used in groundbreaking pediatric surgery

September 19, 2018
Children's Healthcare of Atlanta has performed Georgia's first-ever procedure to place 3-D-printed tracheal splints in a pediatric patient. A cross-functional team of Children's surgeons used three custom-made splints, which ...

Muscle relaxants increase risk of respiratory complications

September 18, 2018
Muscle relaxants are a necessary part of anesthesia during certain major operations. However, studies have hinted at respiratory risks connected with these drugs. POPULAR, a major prospective observational European study ...

Gunshot victims require much more blood and are more likely to die than other trauma patients

September 17, 2018
In a new analysis of data submitted to Maryland's state trauma registry from 2005 to 2017, Johns Hopkins Medicine researchers found that gunshot victims are approximately five times more likely to require blood transfusions, ...

Liver allocation system disadvantages children awaiting transplants

September 17, 2018
Children are at a considerable disadvantage when competing with adults for livers from deceased organ donors in the U.S. allocation system, a University of Pittsburgh Graduate School of Public Health-led analysis reveals ...

Taste preferences connected to success of long-term weight loss after bariatric surgery

September 16, 2018
Following Roux-en-Y gastric bypass (RYGB), a type of bariatric surgery, many patients exhibit a reduction in taste preference for sweet and fatty foods, although this effect may only be temporary, according to new research ...

New insights into what drives organ transplant rejection

September 6, 2018
When it comes to transplant rejection, some organs are far trickier than others. Some transplantable organs, such as the liver, are readily accepted by the recipient's immune system, rarely triggering an immune response and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.