A glenoid defect of 13.5% or larger is not always critical in male competitive rugby and American football players undergoing arthroscopic bony Bankart repair: Contribution of resultant large bone fragment

2021 ◽  
Author(s):  
Shigeto Nakagawa ◽  
Takehito Hirose ◽  
Ryohei Uchida ◽  
Hiroyuki Yokoi ◽  
Tomoki Ohori ◽  
...  
Keyword(s):  
American Football ◽  
Bankart Repair ◽  
Football Players ◽  
Bone Fragment ◽  
Glenoid Defect ◽  
Bony Bankart ◽  
Large Bone

Influence of Glenoid Defect Size and Bone Fragment Size on the Clinical Outcome After Arthroscopic Bankart Repair in Male Collision/Contact Athletes

2017 ◽  
Vol 45 (9) ◽  
pp. 1967-1974 ◽  
Author(s):  
Shigeto Nakagawa ◽  
Tatsuo Mae ◽  
Kenji Yoneda ◽  
Kazutaka Kinugasa ◽  
Hiroyuki Nakamura
Keyword(s):  
Clinical Outcome ◽  
Recurrence Rate ◽  
Fragment Size ◽  
Defect Size ◽  
American Football ◽  
Bone Union ◽  
Bankart Repair ◽  
Bone Fragment ◽  
Glenoid Defect ◽  
Arthroscopic Bankart Repair

Background: The usefulness of arthroscopic Bankart repair for collision/contact athletes has varied in previous reports. Purpose: To investigate the influence of glenoid rim morphologic characteristics on the clinical outcome after arthroscopic Bankart repair without additional reinforcement procedures in male collision/contact athletes, including athletes with a large glenoid defect. Study Design: Case-control study; Level of evidence, 3. Methods: Eighty-six athletes (93 shoulders) followed for a minimum of 2 years were retrospectively investigated. The sports were rugby (36 shoulders), American football (29 shoulders), and other collision/contact sports (28 shoulders). Preoperative glenoid defect size, bone fragment size, and bone union after bony Bankart repair were investigated regarding factors influencing postoperative recurrence. Postoperative changes in glenoid defect size and bone fragment size were investigated as well as their influence on the clinical outcome. Results: Postoperative recurrence of instability was noted in 22 shoulders (23.7%). The recurrence rate was 33.3% in rugby, 17.2% in American football, and 17.9% in other collision/contact sports. The recurrence rate was only 7.1% in 28 shoulders without a preoperative glenoid defect, but it increased to 43.8% in 16 shoulders that did not have a bone fragment even though there was a preoperative glenoid defect. Additionally, the recurrence rate was 7.7% in 26 shoulders with bone union after arthroscopic bony Bankart repair but rose to 45% in 20 shoulders without bone union. In the shoulders with bone union, the mean bone fragment size increased from 8.2% preoperatively to 15.2% postoperatively, while the mean glenoid defect size decreased from 18.0% to 2.8%, respectively. The recurrence rate was 8.3% in shoulders with a final glenoid defect 5% or less versus 38.1% in shoulders with a defect greater than 5%. While the recurrence rate was low among athletes other than rugby players with a final defect of 10% or less, it was low in only the rugby players with a defect of 0%. Conclusion: In male collision/contact athletes, while the overall clinical outcome was unsatisfactory, a favorable outcome was achieved in athletes without a preoperative glenoid defect and athletes with bone union. The glenoid defect decreased in size postoperatively due to remodeling of the united bone fragment, and the recurrence rate was low when the final glenoid defect size was 5% or less.

Effects of Bone Incorporation After Arthroscopic Stabilization Surgery for Bony Bankart Lesion Based on Preoperative Glenoid Defect Size

2018 ◽  
Vol 46 (9) ◽  
pp. 2177-2184 ◽  
Author(s):  
In Park ◽  
Jae-Hoo Lee ◽  
Hwan-Sub Hyun ◽  
Min-Joon Oh ◽  
Sang-Jin Shin
Keyword(s):  
Clinical Outcomes ◽  
Defect Size ◽  
Bankart Lesion ◽  
Bone Fragment ◽  
Recurrence Rates ◽  
Sports Activity ◽  
Glenoid Defect ◽  
Bony Bankart Lesion ◽  
Bony Bankart ◽  
Bone Fragments

Background: Recurrent shoulder instability occurs more frequently after soft tissue surgery when the glenoid defect is greater than 20%. However, for lesions less than 20%, no scientific guidance is available regarding what size of bone fragments may affect shoulder functional restoration after bone incorporation. Purpose/Hypothesis: The purpose was to analyze how preoperative glenoid defect size and bone fragment incorporation alter postoperative clinical outcomes, we compared the functional outcomes of shoulders with and without bony Bankart lesion. It was hypothesized that differences in postoperative clinical outcomes between patients with and without bony fragments would be found only in patients with a larger glenoid defect. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 223 patients who underwent arthroscopic stabilization surgery for recurrent anterior shoulder instability were divided into two groups based on the presence of anterior glenoid bone fragments. In each group, postoperative shoulder functional outcomes, sports activity level, and recurrence rates were evaluated according to preoperative glenoid defect size (small, <10%; medium, 10%-15% and 15%-20%; large, >20%). Results: In patients with small or medium defects, no significant differences were found in postoperative clinical outcomes and sports activity levels between the two groups. However, in patients with a large defect, the patients with bone fragments (mean ± SD American Shoulder and Elbow Surgeons [ASES] score, 92.3 ± 2.7; Rowe score, 90.9 ± 5.4) showed significantly superior clinical outcomes compared with patients who did not have fragments (ASES score, 87.3 ± 6.2, P = .02; Rowe score, 84.8 ± 7.3, P = .04). Among patients without bone fragments, recurrence increased significantly with increasing preoperative glenoid defect size (recurrence rates: 0% in small defects, 7.4% in medium defects, 22.2% in large defects), whereas patients with bone fragments showed no tendency for increasing or decreasing recurrence rates (0% in small defects, 7.9% in medium defects, 5.9% in large defects). Conclusion: In the treatment of bony Bankart lesion, the effect of bone fragment incorporation was different according to preoperative glenoid defect size. In patients with preoperative glenoid defects less than 20% of the glenoid width, bone fragment incorporation after arthroscopic bony Bankart repair did not alter clinical outcomes, sports activity levels, or recurrence rates, whereas in patients with defects greater than 20% of the glenoid width, bone fragment incorporation improved clinical outcomes and recurrence rates.

Remained Large Bone Fragment of Bony Bankart Lesion in Shoulders With a Subcritical Glenoid Defect at Recurrent Anterior Instability

2021 ◽  
pp. 036354652110557
Author(s):  
Shigeto Nakagawa ◽  
Takehito Hirose ◽  
Ryohei Uchida ◽  
Tomoki Ohori ◽  
Tatsuo Mae
Keyword(s):  
Fragment Size ◽  
Postoperative Recurrence ◽  
Defect Size ◽  
Defect Group ◽  
Bone Fragment ◽  
Recurrent Instability ◽  
Glenoid Defect ◽  
Large Defect ◽  
Competitive Athletes ◽  
Large Bone

Background: A preoperative glenoid defect of 13.5% or larger is recognized as a subcritical glenoid defect at arthroscopic Bankart repair (ABR) for collision/contact athletes or military personnel. Purpose: To clarify the prevalence and size of remaining bone fragments in shoulders with a subcritical glenoid defect at recurrent anterior instability and to investigate the influence on postoperative recurrence after ABR for younger competitive athletes. Study Design: Cohort study; Level of evidence, 4. Methods: The study included 96 shoulders with recurrent instability that underwent ABR between July 2011 and March 2018 for shoulders with a subcritical glenoid defect. The patients were divided into 2 groups according to the glenoid defect size (13.5%-<20%, medium; ≥20%, large). The bone fragment size in each defect group was retrospectively investigated and classified into 4 groups (no, 0%; small, >0%-<5%; medium, 5%-<10%; large, ≥10%). The postoperative recurrence rate for each combination of glenoid defect size and bone fragment size was investigated for competitive athletes aged <30 years. The fragments, when present, were repaired to the glenoid. Results: The glenoid defect size was 13.5%-<20% in 60 shoulders (medium defect group) and ≥20% in 36 shoulders (large defect group). The mean bone fragment size was 6.7% ± 5.1% and 8.9% ± 4.9%, respectively ( P = .042). In the medium defect group, there were 15 shoulders (25%) without a bone fragment, 6 shoulders (10%) with a small fragment, 23 shoulders (38.3%) with a medium fragment, and 16 shoulders (26.7%) with a large fragment. In the large defect group, the respective numbers were 2 shoulders (5.6%), 6 shoulders (16.7%), 14 shoulders (38.9%), and 14 shoulders (38.9%). A medium or large bone fragment was more common in the large defect group ( P = .252). Among 64 younger competitive athletes who underwent ABR with a minimum of 2 years of follow-up, postoperative recurrence was recognized in 7 of 38 (18.4%) athletes in the medium defect group, but it was not recognized in any of the 26 athletes in the large defect group ( P = .036). Postoperative recurrence was recognized in 4 of 12 (33.3%) athletes with a small fragment or no fragment and in 3 of 52 (5.8%) athletes with a medium or large fragment ( P = .019). Conclusion: A larger bone fragment frequently remained in shoulders with a subcritical glenoid defect at recurrent instability. The postoperative recurrence rate after ABR for younger competitive athletes was low when a remaining larger bone fragment was repaired.

Quantitative Assessment of Classic Anteroinferior Bony Bankart Lesions by Radiography and Computed Tomography

2003 ◽  
Vol 31 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Eiji Itoi ◽  
Seok-Beom Lee ◽  
Kimberly K. Amrami ◽  
Doris E. Wenger ◽  
Kai-Nan An
Keyword(s):  
Computed Tomography ◽  
Bankart Repair ◽  
West Point ◽  
The West ◽  
Glenoid Defect ◽  
Maximum Width ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Bony Bankart ◽  
Osseous Defect

Background An anteroinferior osseous defect of the glenoid rim is sometimes encountered in patients with recurrent anterior dislocations of the shoulder. A defect of more than 21% of the glenoid length is reported to cause instability after Bankart repair. Hypothesis We can estimate the critical size of glenoid defects by using radiography or computed tomography. Study Design A controlled laboratory study. Methods Osseous defects of 0%, 9%, 21%, 34%, and 46% of the glenoid length were created stepwise in 12 cadaveric scapulae, and plain radiographs simulating the axillary and West Point views and computed tomographic images were obtained. The maximum width of the remnant glenoid was measured under each condition and expressed as a percentage of the width of the intact glenoid. Results A 21% defect appeared to be 18.6% of the intact glenoid on the West Point view. With computed tomography, a 21% defect resulted in loss of 50% of the width on a single slice across the lower one-fourth of the glenoid. Conclusions We can estimate the size of a glenoid defect by using the West Point radiographic view or computed tomogram. Clinical Relevance These images gave decisive information as to whether an osseous glenoid defect required bone grafting to achieve stability after Bankart repair.

Racial and Athletic Identity of African American Football Players

2009 ◽  
Author(s):  
Jesse A. Steinfeldt ◽  
Courtney Reed ◽  
Clint M. Steinfeldt
Keyword(s):  
African American ◽  
Athletic Identity ◽  
American Football ◽  
Football Players

Physical and performance characteristics related to starter status, position, and division in Japanese collegiate American-football players

2021 ◽  
pp. 1-8
Author(s):  
Junta Iguchi ◽  
Minoru Matsunami ◽  
Tatsuya Hojo ◽  
Yoshihiko Fujisawa ◽  
Kenji Kuzuhara ◽  
...  
Keyword(s):  
Performance Test ◽  
Vertical Jump ◽  
American Football ◽  
Football Players ◽  
Jump Height ◽  
Test Results ◽  
Repetition Maximum ◽  
Vertical Jump Height ◽  
Division 1 ◽  
And Performance

BACKGROUND: Few studies have investigated the variations in body composition and performance in Japanese collegiate American-football players. OBJECTIVE: To clarify what characterizes competitors at the highest levels – in the top division or on the starting lineup – we compared players’ body compositions and performance test results. METHODS: This study included 172 players. Each player’s body composition and performance (one-repetition maximum bench press, one-repetition maximum back squat, and vertical jump height) were measured; power was estimated from vertical jump height and body weight. Players were compared according to status (starter vs. non-starter), position (skill vs. linemen), and division (1 vs. 2). Regression analysis was performed to determine characteristics for being a starter. RESULTS: Players in higher divisions and who were starters were stronger and had more power, greater body size, and better performance test results. Players in skill positions were relatively stronger than those in linemen positions. Vertical jump height was a significant predictor of being a starter in Division 1. CONCLUSION: Power and vertical jump may be a deciding factor for playing as a starter or in a higher division.

Player age and initial helmet contact among American football players

2021 ◽  
Vol 47 ◽  
pp. 115-118
Author(s):  
David X. Wang ◽  
Anthony M. Napoli ◽  
Alex R. Webb ◽  
Christine Etzel ◽  
Janette Baird ◽  
...  
Keyword(s):  
American Football ◽  
Football Players

Effect of Turf Toe on Foot Contact Pressures in Professional American Football Players

2009 ◽  
Vol 30 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Robert H. Brophy ◽  
Seth C. Gamradt ◽  
Scott J. Ellis ◽  
Ronnie P. Barnes ◽  
Scott A. Rodeo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
National Football League ◽  
Peak Pressure ◽  
American Football ◽  
Football Players ◽  
Plantar Pressures ◽  
History Of ◽  
Turf Toe ◽  
The Relationship ◽  
Contact Pressures

Background: The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Materials and Methods: Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. Results: First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 ± 15.1 degrees versus 48.4 ± 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 ± 288 kPa versus 414 ± 202 kPa, p = 0.05) even after normalizing for athlete body mass index ( p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. Conclusion: This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

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