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Maggini E, Tedah Djemetio MD, Husband I, Paganelli L, Saccomanno MF, Milano G. Criteria, Timing, and Factors Associated With Return to Competitive Sport After Rotator Cuff Surgery. Sports Med Arthrosc Rev 2024; 32:22-32. [PMID: 38695500 DOI: 10.1097/jsa.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
Rotator cuff pathology in competitive athletes is common and may produce chronic symptoms and joint disability, impairing sports participation and leading to premature retirement. Athletes are a high-functioning patient population with unique characteristics. Decision-making for return to sport is a complex and multifactorial process. Literature is sparse and does not provide precise guidelines to assist physicians to make the right decision. This review aimed to highlight factors affecting outcome, timing, and criteria for return to competitive sport after rotator cuff surgery to help physicians to clearly counsel athletes and make high-quality decisions for return to sport.
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Affiliation(s)
- Emanuele Maggini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Mac Donald Tedah Djemetio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Isabella Husband
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Luca Paganelli
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Maristella F Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Migliorini F, Asparago G, Cuozzo F, Oliva F, Hildebrand F, Maffulli N. Patient outcomes and return to play after arthroscopic rotator cuff repair in overhead athletes: a systematic review. J Orthop Traumatol 2023; 24:3. [PMID: 36656423 PMCID: PMC9852377 DOI: 10.1186/s10195-023-00683-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Rotator cuff tear injuries in overhead athletes are common and may lead to chronic pain and joint disability, impairing sport participation and leading to premature retirement. The improvement of the patient reported outcome measures (PROMs) was evaluated, as were the time and level of return to sport and the rate of complication in overhead athletes who had undergone arthroscopic rotator cuff repair. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In September 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar and Embase. No time constraints were used for the search. All the clinical trials investigating arthroscopic rotator cuff repair in overhead athletes were accessed. RESULTS Data from 20 studies were collected. The mean length of the follow-up was 40 months. All PROMs improved at last follow-up: Kerlan-Jobe Orthopaedic Clinic score (P = 0.02), visual analogue scale (P = 0.003), Constant score (P < 0.0001), University of California Los Angeles Shoulder score (P = 0.006) and American Shoulder and Elbow Surgeons' score (P < 0.0001). Elevation also improved (P = 0.004). No difference was found in external and internal rotation (P = 0.2 and P = 0.3, respectively). In total, 75.4% (522 of 692 of patients) were able to return to play within a mean of 6.4 ± 6.0 months. Of 692 patients, 433 (62.5%) were able to return to sport at pre-injury level. Fourteen out of 138 patients (10.1%) underwent a further reoperation. The overall rate of complications was 7.1% (20 of 280). CONCLUSION Arthroscopic reconstruction of the rotator cuff is effective in improving function of the shoulder in overhead athletes, with a rate of return to sport in 75.4% of patients within an average of 6.4 months. LEVEL OF EVIDENCE III, systematic review. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Filippo Migliorini
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Giovanni Asparago
- grid.11780.3f0000 0004 1937 0335Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA Italy
| | - Francesco Cuozzo
- grid.11780.3f0000 0004 1937 0335Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA Italy
| | - Francesco Oliva
- grid.11780.3f0000 0004 1937 0335Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA Italy
| | - Frank Hildebrand
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Nicola Maffulli
- grid.11780.3f0000 0004 1937 0335Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA Italy ,grid.9757.c0000 0004 0415 6205Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, ST4 7QB Stoke On Trent, England ,grid.4868.20000 0001 2171 1133Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, E1 4DG London, England
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Porcellini G, Ziroglu N, De Santis E, Micheloni GM, Tarallo L, Giorgini A. Midterm Clinical Outcomes After Arthroscopic Rotator Cuff Repair in Olympic Volleyball Players: Return to Sports and Return to Performance. Orthop J Sports Med 2023; 11:23259671231186820. [PMID: 37655246 PMCID: PMC10467408 DOI: 10.1177/23259671231186820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/13/2023] [Indexed: 09/02/2023] Open
Abstract
Background The decision-making process and predicting the time to return to sport (RTS) and return to performance (RTP) after arthroscopic rotator cuff repair (ARCR) in elite volleyball players are difficult issues to address, even among experienced shoulder surgeons. Purpose/Hypothesis The purpose of the study was to evaluate the results in Olympic-level volleyball players treated with arthroscopic supraspinatus repair and to report the RTS and the RTP. It was hypothesized that these athletes had higher RTS and faster RTP. Study Design Case series; Level of evidence, 4. Methods This study included 17 elite volleyball athletes (11 male, 6 female; mean age, 26.2 years) who underwent ARCR for partial- and full-thickness supraspinatus tears that did not improve despite nonoperative treatment. The clinical results were evaluated at 12 months postoperatively. The authors compared the athletes' preoperative, 6-month, and 12-month Kerlan-Jobe Orthopaedic Clinic (KJOC) scores and the visual analog scale (VAS) for pain after competition and conducted 6- and 12-month isometric strength analyses. The athletes' RTS and RTP times were recorded. Results All tears were on the dominant side (15 right, 2 left), and 82% were partial tears (14 partial thickness, 3 full thickness). The mean time from the onset of symptoms to surgery was 11.3 ± 6.7 months. While the mean Kerlan-Jobe Orthopaedic Clinic score was 31 preoperatively, it was 89 after 6 months (P < .001 vs preoperative) and 96 after 12 months (P = .003 vs 6 months). The mean VAS for pain was 7.9 preoperatively, 0.4 at 6 months (P < .001 vs preoperative), and 0.1 at 12 months (P = .02 vs 6 months). All athletes were able to reach their preinjury level, with RTS at a mean of 6.9 months and RTP at a mean of 12.4 months. Conclusion ARCR appears to be an effective option for Olympic-level volleyball players who do not benefit from nonoperative treatment. All athletes returned to their preinjury level of sports. The surgeon and athlete can plan surgical decision-making and timing based on the mean RTS time of 6.9 months and mean RTP time of 12.4 months.
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Affiliation(s)
- Giuseppe Porcellini
- Department of Orthopedics and Traumatology, University of Modena Reggio Emilia, Azienda Ospedaliero–Universitaria di Modena, Modena, Italy
| | - Nezih Ziroglu
- Department of Orthopedics and Traumatology, Acibadem University, Acibadem Atakent Hospital, Kucukcekmece/Istanbul, Turkey
| | | | - Gian Mario Micheloni
- Department of Orthopedics and Traumatology, University of Modena Reggio Emilia, Azienda Ospedaliero–Universitaria di Modena, Modena, Italy
| | - Luigi Tarallo
- Department of Orthopedics and Traumatology, University of Modena Reggio Emilia, Azienda Ospedaliero–Universitaria di Modena, Modena, Italy
| | - Andrea Giorgini
- Department of Orthopedics and Traumatology, University of Modena Reggio Emilia, Azienda Ospedaliero–Universitaria di Modena, Modena, Italy
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Kholinne E, Singjie LC, Marsetio AF, Kwak JM, Jeon IH. Return to physical activities after arthroscopic rotator cuff repair: a systematic review and meta-analysis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023:10.1007/s00590-023-03490-5. [PMID: 36792854 DOI: 10.1007/s00590-023-03490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/05/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Rotator cuff tear is one of the most common disorders in orthopedic surgery. When conservative treatment fails, arthroscopic rotator cuff repair has become the most common procedure to achieve a functional shoulder. HYPOTHESIS/PURPOSE The articles on return to activities following arthroscopic rotator cuff repair have not been collectively analyzed and investigated. We aimed to review systematically and perform a meta-analysis of studies on the return to activities which consist of the return to work, return to sports, and return to daily activities following arthroscopic rotator cuff repair. STUDY DESIGN Systematic Review and Meta-Analysis. METHODS Articles regarding return to activities were systematically searched using databases of PubMed, MEDLINE via EBSCO, ScienceDirect, and ProQuest. The review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. The study protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews. Studies with a level of evidence 1-4 that examined the rate of return to activities after arthroscopic rotator cuff repair were included and analyzed. RESULTS Fifteen studies published between 2005 and 2021 were included, with 1065 patients (644 male and 421 female). The patient populations are workers and athletes. The meta-analysis on the combined effect of a return to activities using the random-effects model was 88.5% (83.8% on return to work, 88.2% on return to sport, and 97.3% on return to daily activities). The mean duration for return to activities is 6.59 months. CONCLUSION As much as 88.5% of patients were able to return to activities after arthroscopic rotator cuff repair with a mean duration of 6.59 months. Preoperative factors (gender, workload, chronicity, tear size, and cholesterol level) may contribute to the rate and duration of return to activities.
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Affiliation(s)
- Erica Kholinne
- Department of Orthopedic Surgery, St. Carous Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
| | | | | | - Jae-Man Kwak
- Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - In-Ho Jeon
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
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5
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Rehabilitation and Return to Work and Sport After Rotator Cuff. Clin Sports Med 2023; 42:175-184. [DOI: 10.1016/j.csm.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sports-Related Shoulder Injuries Among Female Athletes. Curr Rev Musculoskelet Med 2022; 15:637-644. [PMID: 36469281 PMCID: PMC9789246 DOI: 10.1007/s12178-022-09802-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The objectives of this review are to explore the recent literature evaluating sports-related shoulder injuries among female athletes. RECENT FINDINGS Recent literature has highlighted sex-related differences in injury trends and patterns among athletes. Increased participation of women in both recreational and professional sports has resulted in increased exposure to injury. While men experience greater rates of shoulder injury overall, women tend to experience more overuse-related injuries. Evidence also suggests women are more susceptible to shoulder laxity and rotator cuff tears. In comparison to their male counterparts, women note poorer function, increased pain, and decreased activity level following shoulder injuries. Women may also be more likely to experience worse outcomes following surgical intervention. Sex-related differences in injury patterns and outcomes results from a combination of molecular and environmental influences, including hormone pathways, shoulder morphology, and differing rates of participation in, and athletic regulations among, certain sports. Sex-related differences occur in how athletes sustain, experience, and recover from sports-related injuries. A comprehensive understanding of sex-related injuries enhances clinical decision making, treatment, and recovery. Further research is needed to clarify sex as an independent variable when evaluating sports-related shoulder injuries.
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Hogan C, Corbett JA, Ashton S, Perraton L, Frame R, Dakic J. Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis. Am J Sports Med 2021; 49:2843-2853. [PMID: 33211975 DOI: 10.1177/0363546520968508] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Scapular dyskinesis has been considered a risk factor for athletic shoulder injury; however, findings in the prospective literature have demonstrated mixed results. PURPOSE To determine if scapular dyskinesis increases the risk of shoulder injury in athletes. STUDY DESIGN Meta-analysis. METHODS A systematic search was conducted on the MEDLINE, CINAHL Plus, SPORTDiscus, and Embase databases to identify prospective studies examining scapular dyskinesis and shoulder injury risk in athletes. Studies were included if they assessed participants using a dynamic scapular assessment at baseline and monitored for the development of shoulder injury. Data from the studies were subject to meta-analysis using the Mantel-Haenszel method to produce a pooled risk ratio. RESULTS Seven studies were eligible for inclusion, resulting in 212 shoulder injuries observed across 923 athletes. Scapular dyskinesis was present in 46% of participants, and these athletes had an injury rate of 25%. The presence of scapular dyskinesis displayed a trend to increase the risk of shoulder injury, but this was not statistically significant (risk ratio, 1.07; 95% CI, 0.85-1.34; P = .59). CONCLUSION Scapular dyskinesis was not significantly associated with the development of shoulder injury in athletes. REGISTRATION CRD42019133089 (PROSPERO).
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Affiliation(s)
- Campbell Hogan
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Jo-Anne Corbett
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Simon Ashton
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Luke Perraton
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Rachel Frame
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Jodie Dakic
- Department of Physiotherapy, Monash University, Melbourne, Australia
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8
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Davey MS, Hurley ET, Scanlon JP, Gaafar M, Pauzenberger L, Mullett H. Excellent Clinical Outcomes and Rates of Return to Play After Arthroscopic Rotator Cuff Repair for Traumatic Tears in Athletes Aged 30 Years or Less. Arthrosc Sports Med Rehabil 2021; 3:e667-e672. [PMID: 34195630 PMCID: PMC8220565 DOI: 10.1016/j.asmr.2021.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate clinical outcomes and rate of return to play (RTP) among athletes aged 30 years or younger who have undergone an arthroscopic rotator cuff repair (ARCR) after trauma. Methods We performed a retrospective review of patients who underwent an ARCR with a minimum of 12 months’ follow-up between 2012 and 2019. Patients were followed up to assess the American Shoulder and Elbow Surgeons score, Subjective Shoulder Value, visual analog scale score, and satisfaction level. Whether patients were able to RTP was reported, in addition to the timing of return and the level to which they returned. Results Our study included 20 athletes (20 shoulders), with a mean follow-up period of 31.8 months. All patients were satisfied with their surgical procedure, and all would opt to undergo surgery again. Overall, 85% returned to sport and 50.0% returned to the same level or a higher level. The overall mean American Shoulder and Elbow Surgeons score was 92.4; mean Subjective Shoulder Value, 87.0; and mean visual analog scale score, 0.7. At final follow-up, only 1 patient (5.0%) had undergone a revision procedure. Of the 15 patients who played collision sports, 93.3% returned to sport but only 60.0% returned to the same level or a higher level. Conclusions After ARCR, athletes aged 30 years or younger show excellent functional outcomes with high rates of patient satisfaction and RTP after the procedure. Level of Evidence Level IV, therapeutic case series.
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Affiliation(s)
- Martin S Davey
- Sports Surgery Clinic, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eoghan T Hurley
- Sports Surgery Clinic, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland.,National University of Ireland, Galway, Galway, Ireland
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9
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Abstract
PURPOSE OF REVIEW This review presents epidemiology, etiology, management, and surgical outcomes of rotator cuff injuries in tennis players. RECENT FINDINGS Rotator cuff injuries in tennis players are usually progressive overuse injuries ranging from partial-thickness articular- or bursal-sided tears to full-thickness tears. Most injuries are partial-thickness articular-sided tears, while full-thickness tears tend to occur in older-aged players. The serve is the most energy-demanding motion in the sport, and it accounts for 45 to 60% of all strokes performed in a tennis match, putting the shoulder at increased risk of overuse injury and rotator cuff tears. Studies have shown deficits in shoulder range of motion and scapular dyskinesia to occur even acutely after a tennis match. First-line treatment for rotator cuff injuries in any overhead athlete consists of conservative non-operative management with appropriate rest, anti-inflammatory drugs, followed by a specific rehabilitation program. Operative treatment is usually reserved for older-aged players and to those who fail to return to play after conservative measures. Surgical options include rotator cuff debridement with or without tendon repair, biceps tenodesis, and labral procedures. Unlike rotator cuff repairs in the general population, repairs in the elite tennis athlete have less than ideal rates of return to sport to the same level of performance. Rotator cuff injuries are a common cause of pain and dysfunction in tennis players and other overhead athletes. The etiology of rotator cuff tears in tennis players is multifactorial and usually results from microtrauma and internal impingement in the younger athlete leading to partial tearing and degenerative full-thickness tears in older players. Surgical treatment is pursued in athletes who are still symptomatic despite an extensive course of non-operative treatment as outcomes with regard to returning to sport to the same pre-injury level are modest at best. Debridement alone is usually preferred over rotator cuff repairs for partial tears in younger players due to potential over-constraining of the shoulder joint and decreased rates of return to sport after rotator cuff repairs.
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Affiliation(s)
- Rami G. Alrabaa
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
| | - Mario H. Lobao
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
| | - William N. Levine
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
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George A, Saltzman MD, Hsu WK. The Effect of an Arthroscopic Orthopaedic Procedure on a Professional Tennis Player's Career. Cureus 2019; 11:e5654. [PMID: 31720133 PMCID: PMC6822996 DOI: 10.7759/cureus.5654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Orthopaedic injuries can significantly impact the careers of professional tennis players. It is currently unknown how professional tennis players fare after arthroscopic surgery. For the purpose of this study, players ranked in the Association of Tennis Professionals (ATP) and Women’s Tennis Association (WTA) who underwent arthroscopic surgery of any joint between 1996 and 2016 were identified through a well-established, previously published protocol of injury reports and public archives. Performance statistics both before and after surgery, time to return (TTR) to play, and career length following surgery were collected for each player. Statistical analysis was performed with significance accepted at a probability value (p) of <0.05. A total of 55 (39 males and 16 females) players met the inclusion criteria (shoulder, n = 15; elbow, n = 15; wrist, n = 13; hip, n = 12). The average age of the players at the time of surgery was 25.8 (±4) years, and the average career length before surgery was 8.4 (±4) years. Tennis players who underwent arthroscopic shoulder surgery experienced a longer TTR to play (279 days, p <0.01), as well as a greater decline in their rankings, both in the first and second years postoperatively (p <0.01 and p = 0.01, respectively), compared to all other surgical cohorts. Players who underwent surgery on the elbow, wrist, and hip had no significant decline in the ranking by the second postoperative year. There were no significant differences between genders. This study represents the largest database of professional tennis players who have undergone arthroscopic surgery and may allow physicians to provide evidence-based recommendations about expectations after surgical treatment.
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Affiliation(s)
- Andrew George
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Matthew D Saltzman
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Wellington K Hsu
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
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11
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Merolla G, Paladini P, Porcellini G. Assessment of return to play in professional overhead athletes subjected to arthroscopic repair of rotator cuff tears and associated labral injuries using the Italian version of the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow score. Musculoskelet Surg 2018; 102:29-34. [PMID: 29948936 DOI: 10.1007/s12306-018-0547-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The self-administered Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow questionnaire is a reliable and sensitive outcome tool to assess upper extremity athletic performance and functional changes affecting return to play in overhead athletes. We report the results of a study of return to sport in professional overhead athletes at a mean follow-up of 2 years after arthroscopic repair of rotator cuff tears and associated labral injuries using the Italian version of the score. MATERIALS AND METHODS A total number of 38 patients completed the 10-item questionnaire before and after surgery. They were also asked (1) whether they had returned to play; (2) how many months after the operation they had done so; (3) the level of postoperative performance (preinjury or less); and (4) whether they had had to change sport due to their shoulder problems. RESULTS Significant differences were found (1) between preoperative and postoperative scores; (2) between the scores of patients who returned to play at preinjury level and those who merely returned to competition; and (3) between the postoperative subscores of 8/10 items, which were higher in the patients who returned to preinjury performance than in those who merely returned to play; the two items that were not significantly different between these subgroups concerned pain and joint stability. Even though item analysis highlighted a major role for athletic performance in recovery of preinjury performance, it also stressed that the athlete's relationship with coach, agent, and staff and his/her feeling of the extent to which the arm affects current performance significantly contribute to the final score. CONCLUSIONS The KJOC Shoulder and Elbow score provides an accurate and exhaustive assessment of the recovery of the athlete's shoulder in relation to preinjury performance and provides the surgeon with key information on the pros and cons of surgical management.
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Affiliation(s)
- G Merolla
- Shoulder and Elbow Unit, "D. Cervesi" Hospital, AUSL della Romagna Ambito Rimini, Via L.V. Beethoven 5, 47841, Cattolica, Italy.
- Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica, Italy.
| | - P Paladini
- Shoulder and Elbow Unit, "D. Cervesi" Hospital, AUSL della Romagna Ambito Rimini, Via L.V. Beethoven 5, 47841, Cattolica, Italy
| | - G Porcellini
- Orthopaedic and Trauma Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
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Weiss LJ, Wang D, Hendel M, Buzzerio P, Rodeo SA. Management of Rotator Cuff Injuries in the Elite Athlete. Curr Rev Musculoskelet Med 2018; 11:102-112. [PMID: 29332181 PMCID: PMC5825345 DOI: 10.1007/s12178-018-9464-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. RECENT FINDINGS Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness. Rotator cuff injuries can range from contusions and tendinopathy to full-thickness tears. A comprehensive evaluation is needed to determine the extent of injury and appropriate plan of care. Management strategies can range from rehabilitation to operative intervention and are guided by the size of the tear, time of season, sport, performance limitations, and presence of concomitant pathology.
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Affiliation(s)
| | - Dean Wang
- Hospital for Special Surgery, New York, NY, USA
| | | | | | - Scott A Rodeo
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
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13
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Dakic JG, Smith B, Gosling CM, Perraton LG. Musculoskeletal injury profiles in professional Women’s Tennis Association players. Br J Sports Med 2017; 52:723-729. [DOI: 10.1136/bjsports-2017-097865] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/04/2022]
Abstract
ObjectiveThe physical demands of professional tennis combined with high training/match loads can contribute to musculoskeletal injury. The objectives of this study were to (1) describe the type, location and severity of injuries sustained during a 12-month tennis season in a cohort of professional female tennis players on the Women’s Tennis Association (WTA) tour and (2) prospectively investigate associations between training/match loads and injury.Methods52 WTA players competing at the Australian Open (2015) consented to participate. Injuries reported to WTA medical staff were classified using tennis-specific guidelines. Individual match exposure data were collected for all matches played at international level in 2015 and expressed per 1000 hours of WTA competition matchplay (MP) and 1000 match exposures (MEs). Variables associated with the number of injuries in the season and loss of time from competition were identified with regression analysis.ResultsThe injury incidence rate (IR) was 56.6 (95% CI: 49.5 to 64.6) per 1000 hours of MP or 62.7 (95% CI: 54.8 to 71.6) per 1000 MEs, although the IR of injuries resulting in loss of time from competition was lower (12.8 per 1000 hours of MP, 92 injuries/100 players). Lower limb (51%) and muscle/tendon (50%) injuries were the most common site and type of injury. Common specific injury site subcategories were the thigh, shoulder/clavicle, ankle and knee in order of frequency. Various measures of match load were significantly associated with injury.ConclusionThis study prospectively analysed injury profiles, including severity across an entire season of professional tennis, and investigated the relationship between training/match loads and injury. These data may help medical professionals develop injury risk identification and prevention programmes.
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