Tags

Type your tag names separated by a space and hit enter

Internal impingement of the shoulder in overhead athletes: Retrospective multicentre study in 135 arthroscopically-treated patients.

Abstract

BACKGROUND

Internal impingement of the shoulder (IIS) is the leading cause of chronic shoulder pain in overhead throwing athletes. No consensus exists about which techniques are optimal when surgery is in order. The available studies are limited by small sample sizes and short follow-ups. The primary objective of this study was to assess return-to-sports (RtS) outcomes after surgical treatment for IIS. A favourable RtS outcome (RtS+) was defined as returning to the previous sport at the same or a higher level.

HYPOTHESIS

The main hypothesis was that surgical treatment resulted in an RtS+ outcome. The secondary hypothesis was that epidemiological factors, pre- and intra-operative anatomical factors, and specific surgical procedures were associated with higher RtS+ rates.

MATERIAL AND METHODS

A retrospective multicentre design was used. We included 135 patients with IIS managed arthroscopically using any of the following procedures: anterior capsulorrhaphy, posterior capsulotomy/capsulectomy, postero-superior labral debridement, posterior glenoidplasty, and rotator cuff tear debridement or repair. Follow-up was at least 1 year. The patients were divided into two groups based on whether they had an RtS+ outcome as defined above or an RtS- outcome defined as a return to the previous sport at a lower level, a switch to another sport, or an inability to engage in any sport. The Kerlan-Jobe Orthopaedic Clinic (KJOC) and Constant's score were used to evaluate subjective and objective shoulder function.

RESULTS

Mean follow-up was 7.9 years. Of the 135 patients, 120 (90%) returned to sports after surgery including 70 (52%) to the previous sport at the same level (RtS+ outcome). By univariate analysis, the following factors were associated with an RtS+ outcome: male sex, rotator cuff tear documented intra-operatively, absence of a greater tuberosity cyst on pre-operative imaging studies, and cuff tear debridement. Anterior capsulorrhaphy was associated with worse post-operative pain.

DISCUSSION

The RtS+ rate in this study differed from previously reported values, due to differences in the sports practiced by the patients and to considerable variability in the surgical techniques used. The positive association between presence of a rotator cuff tear and an RtS+ outcome is at variance with most of the previously published data. Some of the apparent discrepancies between our results and those from other countries may be ascribable to differences in the most popular sports.

LEVEL OF EVIDENCE

IV.

Authors+Show Affiliations

Service de chirurgie orthopédique, centre hospitalo-universitaire Nancy-Emile Galle, 49, rue Hermite CS 5211, 54052 Nancy, France.Clinique Jouvenet-Ramsay GDS, 6, square Jouvenet, 75016 Paris, France; Institut de recherche en chirurgie osseuse et Sportive (IRCOS), 6, avenue Alphonse XIII, 75016 Paris, France. Electronic address: j.grimberg@lircos.org.Institut universitaire locomoteur et du sport, centre hospitalo-universitaire, hôpital Pasteur 2, 30, Voie Romaine CS 51069-06001, 06000 Nice Cedex 1, France.Institut de l'épaule de Strasbourg, 16, allée de la Robertsau, 67000 Strasbourg, France.Clinique du Parc, 155, boulevard Stalingrad, 69006 Lyon, France.Clinique de l'Union Ramsay GDS, Boulevard Ratalens, 31240 Saint Jean, France.Service de chirurgie du membre supérieur, Hautepierre 2, CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France.Hôpital privé de l'estuaire Ramsay GDS, 505, rue Irène Joliot Curie, 76620 Le Havre, France.Clinique du Parc, 155, boulevard Stalingrad, 69006 Lyon, France.Service de chirurgie orthopédique, université René Descartes Paris V, hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.Service de chirurgie orthopédique & traumatologie de l'appareil moteur, hôpitaux universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.Clinique Jouvenet-Ramsay GDS, 6, square Jouvenet, 75016 Paris, France.15, rue Ampère, 92500 Rueil-Malmaison, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31594731

Citation

Peduzzi, Lisa, et al. "Internal Impingement of the Shoulder in Overhead Athletes: Retrospective Multicentre Study in 135 Arthroscopically-treated Patients." Orthopaedics & Traumatology, Surgery & Research : OTSR, 2019.
Peduzzi L, Grimberg J, Chelli M, et al. Internal impingement of the shoulder in overhead athletes: Retrospective multicentre study in 135 arthroscopically-treated patients. Orthop Traumatol Surg Res. 2019.
Peduzzi, L., Grimberg, J., Chelli, M., Lefebvre, Y., Levigne, C., Kany, J., ... Sanchez, M. (2019). Internal impingement of the shoulder in overhead athletes: Retrospective multicentre study in 135 arthroscopically-treated patients. Orthopaedics & Traumatology, Surgery & Research : OTSR, doi:10.1016/j.otsr.2019.09.006.
Peduzzi L, et al. Internal Impingement of the Shoulder in Overhead Athletes: Retrospective Multicentre Study in 135 Arthroscopically-treated Patients. Orthop Traumatol Surg Res. 2019 Oct 5; PubMed PMID: 31594731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Internal impingement of the shoulder in overhead athletes: Retrospective multicentre study in 135 arthroscopically-treated patients. AU - Peduzzi,Lisa, AU - Grimberg,Jean, AU - Chelli,Mikael, AU - Lefebvre,Yves, AU - Levigne,Christophe, AU - Kany,Jean, AU - Clavert,Philippe, AU - Bertiaux,Simon, AU - Garret,Jérôme, AU - Hardy,Alexandre, AU - Holzer,Nicolas, AU - Sanchez,Matthieu, AU - ,, Y1 - 2019/10/05/ PY - 2019/07/04/received PY - 2019/09/02/accepted PY - 2019/10/10/entrez PY - 2019/10/9/pubmed PY - 2019/10/9/medline KW - Arthroscopic treatment KW - Glenoidplasty KW - Internal impingement of the shoulder KW - Rotator cuff KW - Thrower's shoulder JF - Orthopaedics & traumatology, surgery & research : OTSR JO - Orthop Traumatol Surg Res N2 - BACKGROUND: Internal impingement of the shoulder (IIS) is the leading cause of chronic shoulder pain in overhead throwing athletes. No consensus exists about which techniques are optimal when surgery is in order. The available studies are limited by small sample sizes and short follow-ups. The primary objective of this study was to assess return-to-sports (RtS) outcomes after surgical treatment for IIS. A favourable RtS outcome (RtS+) was defined as returning to the previous sport at the same or a higher level. HYPOTHESIS: The main hypothesis was that surgical treatment resulted in an RtS+ outcome. The secondary hypothesis was that epidemiological factors, pre- and intra-operative anatomical factors, and specific surgical procedures were associated with higher RtS+ rates. MATERIAL AND METHODS: A retrospective multicentre design was used. We included 135 patients with IIS managed arthroscopically using any of the following procedures: anterior capsulorrhaphy, posterior capsulotomy/capsulectomy, postero-superior labral debridement, posterior glenoidplasty, and rotator cuff tear debridement or repair. Follow-up was at least 1 year. The patients were divided into two groups based on whether they had an RtS+ outcome as defined above or an RtS- outcome defined as a return to the previous sport at a lower level, a switch to another sport, or an inability to engage in any sport. The Kerlan-Jobe Orthopaedic Clinic (KJOC) and Constant's score were used to evaluate subjective and objective shoulder function. RESULTS: Mean follow-up was 7.9 years. Of the 135 patients, 120 (90%) returned to sports after surgery including 70 (52%) to the previous sport at the same level (RtS+ outcome). By univariate analysis, the following factors were associated with an RtS+ outcome: male sex, rotator cuff tear documented intra-operatively, absence of a greater tuberosity cyst on pre-operative imaging studies, and cuff tear debridement. Anterior capsulorrhaphy was associated with worse post-operative pain. DISCUSSION: The RtS+ rate in this study differed from previously reported values, due to differences in the sports practiced by the patients and to considerable variability in the surgical techniques used. The positive association between presence of a rotator cuff tear and an RtS+ outcome is at variance with most of the previously published data. Some of the apparent discrepancies between our results and those from other countries may be ascribable to differences in the most popular sports. LEVEL OF EVIDENCE: IV. SN - 1877-0568 UR - https://www.unboundmedicine.com/medline/citation/31594731/Internal_impingement_of_the_shoulder_in_overhead_athletes:_Retrospective_multicentre_study_in_135_arthroscopically-treated_patients L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-0568(19)30262-2 DB - PRIME DP - Unbound Medicine ER -