Arthroscopic and Open Stabilization Techniques for Anterior Instability in the Contact Athlete.pdfVIP

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2017-03-16 发布于天津
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Arthroscopic and Open Stabilization Techniques for Anterior Instability in the Contact Athlete.pdf

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Arthroscopic and Open Stabilization Techniques for Anterior Instability in the Contact Athlete.pdf

Arthroscopic and Open Stabilization Techniques for Anterior Instability in the Contact Athlete Ariel A. Williams, MD, and Robert A. Arciero, MD Shoulder dislocations are common injuries seen in contact athletes and can cause substantial time away from play, reduce career length, and result in serious long-term morbidity. Contact athletes may be at higher risk for failure of surgical repair of shoulder instability than other individuals. In light of these issues, the contact athlete with shoulder instability deserves special attention. A number of surgical techniques have been described for treatment of shoulder instability in contact athletes, ranging from arthroscopic to open Bankart repair to bone block procedures. In this article, we review the clinical evaluation of the contact athlete with shoulder instability, including history taking, physical examination, and imaging ?ndings. We discuss decision making for repair in terms of both timing and choice of procedure. Finally, we discuss techniques of arthroscopic and open Bankart repair and outcomes. Oper Tech Sports Med 24:278-285 C 2016 Elsevier Inc. All rights reserved. KEYWORDS Bankart repair, capsulorrhaphy, shoulder instability, contact athlete Introduction Shoulder injuries are among the most frequent injuries sustained by contact athletes, and shoulder dislocations are among the most common shoulder injuries in this population.1-6 One study of 336 college football players in the National Football League Combine found that 49.7% of players had had a shoulder injury in their career, and 20% of these had been anterior shoulder dislocations. In this same group, anterior instability surgery comprised 76% of prior surgeries.2 A study of 378 high school rugby players found that 14.8% had had prior shoulder dislocations and reported the incidence rate of shoulder dislocations to be 55.6 per 1000 player-seasons.6 In young patients under 25 years of age, the risk of recurrence after a ?rst-time shoulder dislocation