美国大学橄榄球运动员在接受关节镜肩唇修复后的修复率很低

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI:10.1016/j.asmr.2024.101028

Camila Grandberg M.D. , Ian D. Engler M.D. , Neilen A. Benvegnu M.D. , Janina Kaarre M.D., M.Sc. , Adam J. Popchak D.P.T., Ph.D. , Michael S. Rocca M.D. , Brian M. Godshaw M.D. , Jonathan D. Hughes M.D., Ph.D. , Volker Musahl M.D.

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引用次数: 0

摘要

目的描述1级（D1）大学美式橄榄球运动员因肩部不稳定接受关节镜下唇部修复手术的翻修手术率和复发事件，并评估其功能结局和恢复比赛（RTP）。方法纳入2017年至2021年在同一机构接受关节镜手术治疗肩关节不稳的1名美式橄榄球大学生运动员。收集了人口统计学、影像学、手术细节和术后结果，包括翻修手术和西安大略省肩部不稳定指数（WOSI）。磁共振成像评价Hill-Sachs病变和肩关节骨丢失。结果连续纳入15例男性运动员15肩，平均年龄19.7±1.0岁，平均随访2.1±1.0年。12例为肩部半脱位，3例为脱位。后路损伤7例，前路损伤4例，前后路均损伤4例。所有患者均行关节镜下阴唇修复术，无复发或任何其他开放手术。每个肩部平均使用6个锚，锚至少放置在2个象限。Hill-Sachs病变6例（40%）。13个肩部没有肩胛盂骨丢失，2个肩胛盂骨丢失15%。两个肩膀需要翻修手术。术后WOSI评分在有无复发性不稳定患者（66.9±11.5% vs 94.6±5.0%）、有无Hill-Sachs病变患者（84.6±14.7% vs 95.0±5.9%）之间存在显著差异。14例患者（93%）RTP处于相同水平。结论关节镜下唇部修复术治疗D1美式橄榄球运动员肩关节不稳，无需再灌注/骨块手术，复发率和翻修率低，RTP率高。此外，Hill-Sachs病变和复发性肩部不稳定与较差的术后主观结果（WOSI评分）相关。证据水平：IV级，治疗性病例系列。

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Division 1 Collegiate American Football Players Experience a Low Revision Rate After Undergoing Arthroscopic Shoulder Labral Repair

Purpose

To describe rates of revision surgery and recurrence events, as well as to evaluate functional outcomes and return to play (RTP) of a cohort of Division 1 (D1) collegiate American football players who underwent arthroscopic labral repair for shoulder instability.

Methods

D1 collegiate American football players undergoing arthroscopic surgical management of shoulder instability between 2017 and 2021 at a single institution were included. Demographics, imaging, surgical details, and postoperative outcomes, including revision surgery and Western Ontario Shoulder Instability Index (WOSI), were collected. Hill-Sachs lesions and glenoid bone loss were evaluated on magnetic resonance imaging.

Results

Fifteen shoulders of 15 consecutive male athletes were included, with mean age of 19.7 ± 1.0 years and mean follow-up of 2.1 ± 1.0 years. Twelve injuries were shoulder subluxations and 3 were dislocations. Seven cases were posterior injuries, 4 were anterior, and 4 included both anterior and posterior injuries. All patients underwent arthroscopic labrum repair alone, without remplissage or any additional open procedures. A mean of 6 anchors were used in each shoulder, with anchors being placed in at least 2 quadrants. Hill-Sachs lesions were observed in 6 shoulders (40%). Thirteen shoulders had no glenoid bone loss, and 2 had >15% glenoid bone loss. Two shoulders required revision surgery. Significant differences were found in postoperative WOSI scores between patients with and without recurrent instability (66.9 ± 11.5% vs 94.6 ± 5.0%), and between patients with and without Hill-Sachs lesions (84.6 ± 14.7% vs 95.0 ± 5.9%). Fourteen patients (93%) RTP at the same level.

Conclusions

Arthroscopic labral repairs as a treatment for shoulder instability in D1 American football players, without remplissage/bone block procedures, yielded low recurrence and revision rates, and a high RTP rate. Additionally, Hill-Sachs lesions and recurrent shoulder instability were associated with inferior postoperative subjective outcomes (WOSI score).