Cargando…

Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?

BACKGROUND: Because of the high risk for redislocations after a first-time traumatic anterior shoulder dislocation with conservative treatment, recent publications have recommended early arthroscopic intervention, especially for young athletes. Concomitant rotator cuff tendon damage may occur when t...

Descripción completa

Detalles Bibliográficos
Autores principales: Rahu, Madis, Kartus, Jüri-Toomas, Põldoja, Elle, Pedak, Kirsti, Kolts, Ivo, Kask, Kristo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077916/
https://www.ncbi.nlm.nih.gov/pubmed/30090831
http://dx.doi.org/10.1177/2325967118781311
_version_ 1783345002411196416
author Rahu, Madis
Kartus, Jüri-Toomas
Põldoja, Elle
Pedak, Kirsti
Kolts, Ivo
Kask, Kristo
author_facet Rahu, Madis
Kartus, Jüri-Toomas
Põldoja, Elle
Pedak, Kirsti
Kolts, Ivo
Kask, Kristo
author_sort Rahu, Madis
collection PubMed
description BACKGROUND: Because of the high risk for redislocations after a first-time traumatic anterior shoulder dislocation with conservative treatment, recent publications have recommended early arthroscopic intervention, especially for young athletes. Concomitant rotator cuff tendon damage may occur when the shoulder dislocates; however, its presence and influence on clinical results have not been well described in this patient category. HYPOTHESIS: In opposition to current opinion, a substantial number of articular-sided partial-thickness rotator cuff tears (APTRCTs) would be found at surgery after a first-time traumatic anterior shoulder dislocation in young athletes. However, the impact of these injuries on 2-year postoperative results would be negligible. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Sixteen male patients (mean age, 21 years [range, 16-25 years]) with a first-time traumatic anterior shoulder dislocation without bony Bankart lesions were included in this study. The indications for surgical treatment were age less than 25 years and being active in collision or contact sports at a competitive level. Arthroscopic surgery was performed at a mean 7.8 days (range, 2-14 days) after injury. Rowe and American Shoulder and Elbow Surgeons (ASES) scores as well as range of motion were evaluated at a minimum 2 years after an arthroscopic Bankart procedure, and a comparison of the clinical results between patients with and without APTRCTs was conducted. RESULTS: An anterior-inferior capsulolabral injury was found in all patients. There were no bony Bankart lesions. An APTRCT was found in 9 of the 16 patients. At 2 years after surgical treatment, there were no significant differences between the patients with and without APTRCTs in terms of the Rowe score (90.0 and 87.1, respectively; P = .69) and ASES score (94.6 and 90.4, respectively; P = .67). CONCLUSION: APTRCTs were found in the superior part of the shoulder joint after a first-time traumatic anterior shoulder dislocation in a majority of young male athletes treated with surgical stabilization. There were no significant differences found between patients with and without APTRCTs in terms of the Rowe and ASES scores at 2 years after surgical treatment.
format Online
Article
Text
id pubmed-6077916
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-60779162018-08-08 Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization? Rahu, Madis Kartus, Jüri-Toomas Põldoja, Elle Pedak, Kirsti Kolts, Ivo Kask, Kristo Orthop J Sports Med Article BACKGROUND: Because of the high risk for redislocations after a first-time traumatic anterior shoulder dislocation with conservative treatment, recent publications have recommended early arthroscopic intervention, especially for young athletes. Concomitant rotator cuff tendon damage may occur when the shoulder dislocates; however, its presence and influence on clinical results have not been well described in this patient category. HYPOTHESIS: In opposition to current opinion, a substantial number of articular-sided partial-thickness rotator cuff tears (APTRCTs) would be found at surgery after a first-time traumatic anterior shoulder dislocation in young athletes. However, the impact of these injuries on 2-year postoperative results would be negligible. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Sixteen male patients (mean age, 21 years [range, 16-25 years]) with a first-time traumatic anterior shoulder dislocation without bony Bankart lesions were included in this study. The indications for surgical treatment were age less than 25 years and being active in collision or contact sports at a competitive level. Arthroscopic surgery was performed at a mean 7.8 days (range, 2-14 days) after injury. Rowe and American Shoulder and Elbow Surgeons (ASES) scores as well as range of motion were evaluated at a minimum 2 years after an arthroscopic Bankart procedure, and a comparison of the clinical results between patients with and without APTRCTs was conducted. RESULTS: An anterior-inferior capsulolabral injury was found in all patients. There were no bony Bankart lesions. An APTRCT was found in 9 of the 16 patients. At 2 years after surgical treatment, there were no significant differences between the patients with and without APTRCTs in terms of the Rowe score (90.0 and 87.1, respectively; P = .69) and ASES score (94.6 and 90.4, respectively; P = .67). CONCLUSION: APTRCTs were found in the superior part of the shoulder joint after a first-time traumatic anterior shoulder dislocation in a majority of young male athletes treated with surgical stabilization. There were no significant differences found between patients with and without APTRCTs in terms of the Rowe and ASES scores at 2 years after surgical treatment. SAGE Publications 2018-06-26 /pmc/articles/PMC6077916/ /pubmed/30090831 http://dx.doi.org/10.1177/2325967118781311 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Rahu, Madis
Kartus, Jüri-Toomas
Põldoja, Elle
Pedak, Kirsti
Kolts, Ivo
Kask, Kristo
Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title_full Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title_fullStr Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title_full_unstemmed Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title_short Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?
title_sort do articular-sided partial-thickness rotator cuff tears after a first-time traumatic anterior shoulder dislocation in young athletes influence the outcome of surgical stabilization?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077916/
https://www.ncbi.nlm.nih.gov/pubmed/30090831
http://dx.doi.org/10.1177/2325967118781311
work_keys_str_mv AT rahumadis doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization
AT kartusjuritoomas doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization
AT poldojaelle doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization
AT pedakkirsti doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization
AT koltsivo doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization
AT kaskkristo doarticularsidedpartialthicknessrotatorcufftearsafterafirsttimetraumaticanteriorshoulderdislocationinyoungathletesinfluencetheoutcomeofsurgicalstabilization