title: Anterior shoulder capsular tears in professional baseball players.
abstract: BACKGROUND
  Tearing of the anterior capsule of the shoulder is a rare but debilitating injury for throwing athletes. However, there is very little in the literature to guide its diagnosis and treatment. In this case series, we outline our experience with anterior capsular tears of the shoulder in professional baseball players.
  
  
  METHODS
  Five professional baseball players were diagnosed with midsubstance tears of their anterior capsule. A trial of rest and rehabilitation failed in all patients, and they eventually underwent surgery. These patients were retrospectively reviewed. The presenting symptoms and findings were documented, and outcomes were assessed by the player's ability to return to play.
  
  
  RESULTS
  The mean age was 33.5 years (range, 31-37 years), and all patients presented with anterior shoulder pain and the inability to throw. No patient had an acute traumatic injury. Magnetic resonance imaging provided the correct diagnosis in 4 patients, and the diagnosis was made with diagnostic arthroscopy in the fifth. Three underwent arthroscopic repair, and 2 underwent open repair of the anterior capsule. Of the 5 players, 4 (80%) returned to their preinjury level by a mean of 13.3 months (range, 8-18 months).
  
  
  CONCLUSIONS
  Anterior capsular tears can occur in older throwing athletes. Surgical repair, whether arthroscopic or open, can yield good results in most patients.
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA. Electronic address: GulottaL@hss.edu.
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Gulotta
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lobatto
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Demetris
authors.initials: D
authors.lastname: Delos
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Struan H
authors.initials: SH
authors.lastname: Coleman
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
mesh_terms: D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000175:diagnosis / Q000601:surgery*; D001484:Baseball / Q000293:injuries*; D006801:Humans; D017746:Joint Capsule / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology
keywords: Throwing athletes; baseball; shoulder; shoulder capsule