[Capacity for sport and the sensorimotor system after stabilization of the shoulder in overhead athletes].
The anterior capsulolaboral reconstruction according to Jobe is a modification of the Bankart operation, performing the capsular shift via a subscapularis-split approach avoiding any incision into the musculature. A total of 24 overhead athletes with posttraumatic, chronic anterior shoulder instability underwent surgery. Twenty-two patients were examined after an average follow-up of 2.8 +/- 0.7 years. On average, a Constant-Murley-Score of 93.7 +/- 5.3 points and an ASES-Score of 95.0 +/- 5.1 points were achieved. The relaxation rate was 9 %. The study demonstrated, that despite the good clinical results, only 12 out of 22 (55 %) of patients were able to return to their previous sports activity level. This relevant problem is in agreement with other similar studies so that it was further addressed by determination of proprioception and electromyographic muscle activity. Postoperatively, a persisting proprioceptive deficit as well as an altered EMG pattern was found with a significant reduction in activity of the deltoideus muscle on the operated side. The analysis of the data of each patient showed that there was a significant relation between the restitution of proprioception and ability to return to the previous sports activity level. In contrast, the relation between EMG pattern and full recovery to completely unrestricted shoulder function was not significant.
Fremerey
R W
RW
Klinikum Hildesheim GmbH, Hildesheim. ReinhardFremerey@t-online.de
Bosch
U
U
Lobenhoffer
P
P
Stalp
M
M
Wippermann
B
B
D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods; D001265:Athletic Injuries / Q000175:diagnosis* / Q000601:surgery*; D004576:Electromyography; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology*; D012785:Shoulder Joint / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D020886:Somatosensory Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome