title: Posterior Shoulder Instability in Throwing Athletes: A Case-Matched Comparison of Throwers and Non-Throwers.
abstract: OBJECTIVE
  To evaluate the results of arthroscopic capsulolabral repair for the treatment of posterior shoulder instability in a throwing athlete cohort when compared with non-throwers.
  
  
  METHODS
  Forty-eight overhead-throwing athletes undergoing arthroscopic posterior capsulolabral reconstruction were case matched with 48 non-throwing athletes. These cohorts were followed as they underwent posterior capsulolabral reconstruction by measuring shoulder pain, function, return to sport, and operative failures. Operative details such as intra-articular pathology and repair construct were also recorded.
  
  
  RESULTS
  At a mean follow-up of 37 months (range, 12 to 97 months) postoperatively, no statistical differences were noted between throwers and non-throwers regarding American Shoulder and Elbow Surgeons scores, stability, strength, or range of motion. Sixty percent of throwing athletes were able to return to their preinjury level of competitive throwing. Throwers with a discrete labral tear intraoperatively had a 10-fold increased likelihood of returning to sport (odds ratio, 9.6; P = .012). Similarly, throwers who had suture anchor constructs showed a 10-fold increased likelihood of returning to play compared with anchor-less repairs (odds ratio, 9.6; P = .012). Non-throwers showed no variability by labral findings or fixation techniques. Pitchers had equivocal outcome scores when compared with other throwers but had poorer return-to-play rates (50% v 60% full return).
  
  
  CONCLUSIONS
  Arthroscopic capsulolabral plication for unidirectional posterior shoulder instability is an effective treatment for overhead-throwing athletes. Intraoperatively, achieving an adequate capsular plication and stabilizing the repair with suture anchors will give this athletic population the best odds of returning to competitive sports.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.. Electronic address: mcclincymp@upmc.edu.
authors.forename: Michael P
authors.initials: MP
authors.lastname: McClincy
authors.affiliation: Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Justin W
authors.initials: JW
authors.lastname: Arner
authors.affiliation: Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.; Burke and Bradley Orthopedics, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries / Q000534:rehabilitation / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000534:rehabilitation / Q000601:surgery; D013177:Sports / Q000502:physiology; D053441:Suture Anchors; D016896:Treatment Outcome