Arthroscopic management of the contact athlete with instability.
The shoulder is the most commonly dislocated joint in the body, with a greater incidence of instability in contact and collision athletes. In contact and collision athletes that have failed nonoperative treatment, the most important factors to consider when planning surgery are amount of bone loss (glenoid, humeral head); patient age; and shoulder hyperlaxity. Clinical outcomes, instability recurrence rate, and return to sport rate are not significantly different between arthroscopic suture anchor and open techniques. Lateral decubitus positioning with distraction and four portal (including seven-degree and 5-o’clock positions) techniques allow for 360-degree access to the glenoid rim, with placement of at least three sutures anchors below 3 o’clock for optimal results. In patients with significant glenoid bone loss (>20%-25%, inverted pear glenoid), open bone augmentation techniques are indicated and arthroscopic techniques are contraindicated.
The Methodist Center for Sports Medicine, Division of Sports Medicine, Department of Orthopaedic Surgery, 6560 Fannin Street, Scurlock Tower, Suite 400, Houston, TX 77030, USA. Electronic address: joshuaharrismd@gmail.com.
Joshua D
JD
Harris
Anthony A
AA
Romeo
D000465:Algorithms; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003661:Decision Support Techniques; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012783:Shoulder Dislocation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome
Arthroscopy; Athlete; Dislocation; Instability; Shoulder