Combined Arthroscopic Bankart Repair and Coracoid Process Transfer to Anterior Glenoid for Shoulder Dislocation in Rugby Players: Evaluation Based on Ability to Perform Sport-Specific Movements Effectively.
OBJECTIVE
To evaluate the outcomes of a combination of an arthroscopic Bankart repair and an open Bristow procedure in relation to the subjective quality of performance in movements that are typical in rugby.


METHODS
Forty shoulders in 38 players who underwent surgery for traumatic anterior instability of the shoulder were reviewed. In all cases, arthroscopic Bankart repair was followed by a Bristow procedure, with preservation of the repaired capsular ligaments, during the same operation. The mean age at the time of surgery was 21 years. Patients were asked to describe common rugby maneuvers (tackle, hand-off, jackal, and saving) preoperatively and postoperatively as "no problem," "insufficient," or "impossible."


RESULTS
There were no recurrent dislocations at a mean follow-up of 30.5 months. The mean Rowe score improved significantly from 65.0 (range, 55 to 75) to 97.5 (range, 95 to 100) (P < .001) after surgery. Preoperatively, regarding the tackling motion, none of the patients reported having no problem, whereas the ability was described as insufficient for 23 shoulders and impossible for 17 shoulders. Postoperatively, no problem with tackling was reported for 36 shoulders, whereas insufficiency was reported for 4. The results for the hand-off, jackal, and saving maneuvers were similar (P < .001). No patient rated any of the motions as impossible postoperatively.


CONCLUSIONS
This combined surgical procedure clearly is effective in preventing recurrent dislocation in rugby players; however, some players complained of insufficiency in the quality of their play when they were tackling or performing other rugby-specific movements.


METHODS
Level IV, case series.
Department of Orthopedic Surgery, St. Luke's International Hospital, Tokyo, Japan. Electronic address: tatsu@luke.ac.jp.
Atsushi
A
Tasaki
Division of Surgery and Interventional Science, University College London, London, England.
Wataru
W
Morita
Division of Clinical Biotechnology, University of Tokyo, Tokyo, Japan.
Akira
A
Yamakawa
Department of Radiology, St. Luke's International Hospital, Tokyo, Japan.
Taiki
T
Nozaki
Department of Orthopedic Surgery, St. Luke's International Hospital, Tokyo, Japan.
Eishi
E
Kuroda
Department of Orthopedic Surgery, St. Luke's International Hospital, Tokyo, Japan.
Yoshimitsu
Y
Hoshikawa
Department of Orthopaedic Surgery, Division of Sports Medicine, University of Tennessee-Campbell Clinic, Memphis, Tennessee, U.S.A.
Barry B
BB
Phillips
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D005538:Football / Q000293:injuries*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D012540:Scapula / Q000601:surgery*; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult