scholarly journals Risk Factors for Revision Posterior Shoulder Stabilization in Throwing Athletes

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096765
Author(s):  
Ravi Vaswani ◽  
Justin Arner ◽  
Halle Freiman ◽  
James P. Bradley
Keyword(s):  
Risk Factors ◽  
Revision Surgery ◽  
Sport Participation ◽  
Female Athletes ◽  
Revision Rate ◽  
Return To Sports ◽  
Shoulder Stabilization ◽  
Bone Width ◽  
Posterior Shoulder ◽  
Significant Difference

Background: Revision posterior shoulder capsulolabral repair has inferior outcomes compared with primary surgery. Risk factors for revision in throwing athletes are unknown. Purpose/Hypothesis: The purpose of this study was to characterize the revision rate and risk factors for revision surgery in throwing athletes. It was hypothesized that female athletes and those with smaller glenoid bone width would be at higher risk for revision surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 105 throwing athletes who underwent arthroscopic posterior capsulolabral repair of their throwing shoulder were reviewed at a minimum of 2-year follow-up, and patients who required a revision were compared with those who did not. Collected data compared between the revision and no-revision groups included age, sex, contact sport participation, and return to sport (RTS). American Shoulder and Elbow Surgeons (ASES) score, Kerlan-Jobe Orthopaedic Clinic (KJOC) score, stability, pain, strength, range of motion (ROM), and patient satisfaction. Radiographic parameters including glenoid bone version, cartilage version, labral version, bone width, labral width, glenoid labral version and width weight were also compared between both groups. Results: Nine throwers required revision (8.6%) at an average of 2.8 years postoperatively. There were more female athletes in the revision than no-revision group (55.5% vs 23.4%; P = .03). There was no significant difference in age, proportion of contact athletes, rotator cuff tears, glenoid bone version, cartilage version, labral version, labral version weight, bone width, labral width, or labral width weight. Both groups had similar preoperative, postoperative, and change in ASES, KJOC, pain, strength, stability, and ROM scores. The proportion of patients with full strength and with full ROM, as well as patients who were satisfied with outcomes was similar between groups. Fewer patients in the revision group returned to sports compared with those in the no-revision group (14.3% vs 83.6%; P < .001), although return to sports at same level was not significantly different between groups (14.3% vs 37.2%; P = .41). Conclusion: The revision rate of arthroscopic posterior shoulder stabilization in throwers was 8.6%. Female athletes were at higher risk for revision, and return to sports was lower in patients who underwent revision surgery.

scholarly journals Risk Factors and Outcomes of Revision Arthroscopic Posterior Shoulder Capsulolabral Repair in Contact Athletes

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0031
Author(s):  
Justin W. Arner ◽  
Sachidhanand Jayakumar ◽  
Dharmesh Vyas ◽  
James P. Bradley
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Revision Surgery ◽  
Significant Risk ◽  
Return To Sport ◽  
Significant Risk Factor ◽  
Return To Play ◽  
Bone Width ◽  
Posterior Shoulder

Objectives: Risk factors and outcomes of revision arthroscopic posterior capsulolabral repairare currently not well defined in contact athletes.Evaluation of risk factors for contact athletes who require revision arthroscopic posterior unidirectional capsulolabral repair is needed. Methods: A total of 186 contact athletes’ shoulders that underwent arthroscopic posterior capsulolabral repair at minimum 2 year follow-up were reviewed. Those who required revision surgery were compared with those who did not. Parameters assessed included age, gender, labral and/or capsular injury, level of sport, and return to sport. Glenoid bone width, bone version, labral width, and labral version were also compared. Results: Eleven shoulders required revision surgery (5.9%) at mean 12.0 year follow-up. The only significant risk factor was glenoid bone width (revision=26.4 mm vs. non-revision=29.1 mm, p=0.005). Cartilage version (p=0.676), labral version (p=0.539), and bone version (p=0.791) were not significantly different between groups, nor was labral width (p=0.751). Gender (p=0.326), labral injury (p=0.349), capsule injury (p=0.683), and level of sport (p=0.381) were not significant factors for requiring revision surgery. Both return to sport at the same level (revision=16.7% vs. non-revision=72.1%, p<0.001) and overall return to sport (revision=50% vs. non-revision=93.7%, p<0.001) was significantly worse in the revision group. Of those who had revision surgery, 33.3% stated their original surgery was not worthwhile, which was significantly higher than the 4.5% in the non-revision group (p=0.041). Conclusion: Contact athletes underwent revision arthroscopic posterior capsulolabral repair at an incidence of 5.9% at 12 year follow-up. The only significant risk factor for requiring revision surgery was smaller glenoid bone width. Return to play was significantly worse in those who required revision surgery. This data is essential for patient selection, optimal treatment techniques, and patient education as posterior shoulder capsulolabral repair in contact athletes that require revision has not previously been evaluated.

Risk Factors and Outcomes of Revision Arthroscopic Posterior Shoulder Capsulolabral Repair

2018 ◽  
Vol 46 (10) ◽  
pp. 2457-2465 ◽  
Author(s):  
James P. Bradley ◽  
Justin W. Arner ◽  
Sachidhanand Jayakumar ◽  
Dharmesh Vyas
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Range Of Motion ◽  
Revision Surgery ◽  
Return To Play ◽  
Female Sex ◽  
Bone Width ◽  
Posterior Shoulder ◽  
Rotator Cuff Injury

Background: Risk factors and outcomes of revision arthroscopic posterior capsulolabral repair of the shoulder are currently not well defined. Hypothesis: Athletes who require revision arthroscopic posterior unidirectional capsulolabral repair will have poorer outcomes and return to play when compared with those undergoing primary procedures, with risk factors including younger age, injury size, bone loss, and anchor number. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 297 shoulders that underwent arthroscopic posterior capsulolabral repair at minimum 2-year follow-up were reviewed. In addition to surgical data, the American Shoulder and Elbow Surgeons scoring system with subjective stability, range of motion, strength, and pain scores as well as return to sport were compared pre- and postoperatively between those who did and did not require revision surgery. Magnetic resonance arthrogram measurements of glenoid labral, chondral, and bone version and labral and bone width were also compared. Results: Nineteen shoulders required revision surgery (6.4%) at 8.9-year follow-up. Significant risk factors included female sex ( P = .001), dominant shoulder ( P = .005), and concomitant rotator cuff injury ( P = .029). Patients with ≤3 anchors were more likely to require revision (odds ratio = 3.48). Smaller glenoid bone width was a risk factor for requiring future revision surgery ( P < .001), but glenoid labral, chondral, and bone version and labral width were not risk factors. All patients had significant improvements in American Shoulder and Elbow Surgeons, pain, range of motion, and strength scores after the original surgery; however, those who required revision surgery had less improvement ( P < .05). Stability improved significantly for nonrevisions ( P < .001) but did not for revisions ( P = .662). In the nonrevision group, 64.3% returned to sport at the same level, which was significantly higher than the 15.4% of the revision group ( P = .004). Overall, 78.6% of the nonrevision group and 61.6% of the revision group returned to sport at some level ( P = .280). Conclusion: Athletes underwent revision arthroscopic posterior capsulolabral repair at an incidence of 6.4%. Revision patients had significantly poorer outcome scores and return to play when compared with those who did not undergo revision surgery with risk factors being dominant shoulder surgery, female sex, concomitant rotator cuff injury, the use of 3 or fewer anchors, and smaller glenoid bone width. These data are essential for patient selection, optimal treatment techniques, and patient education as posterior shoulder instability failure requiring revision has not previously been evaluated.

scholarly journals Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711882245 ◽  
Author(s):  
Ellie A. Moeller ◽  
Darby A. Houck ◽  
Eric C. McCarty ◽  
Adam J. Seidl ◽  
Jonathan T. Bravman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Return To Sport ◽  
Patient Reported Outcome ◽  
Shoulder Stabilization ◽  
Posterior Shoulder ◽  
Significant Difference ◽  
Patient Reported ◽  
Instability Rate

Background: Arthroscopic posterior shoulder stabilization can be performed with patients in the beach-chair (BC) and the lateral decubitus (LD) positions; however, the impact of patient positioning on clinical outcomes has not been evaluated. Purpose: To compare clinical outcomes and recurrence rates after arthroscopic posterior shoulder stabilization performed in the BC and LD positions. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library for studies reporting the clinical outcomes of patients undergoing arthroscopic posterior shoulder stabilization in either the BC or LD position. All English-language studies from 1990 to 2017 reporting clinical outcomes after arthroscopic posterior shoulder stabilization with a minimum 2-year follow-up were reviewed by 2 independent reviewers. Data on the recurrent instability rate, return to activity or sport, range of motion, and patient-reported outcome scores were collected. Study methodological quality was evaluated using the Modified Coleman Methodology Score (MCMS) and Quality Appraisal Tool (QAT). Results: A total of 15 studies (11 LD, 4 BC) with 731 shoulders met the inclusion criteria, including 626 shoulders in the LD position (mean patient age, 23.9 ± 4.1 years; mean follow-up, 37.5 ± 10.0 months) and 105 shoulders in the BC position (mean patient age, 27.8 ± 2.2 years; mean follow-up, 37.9 ± 16.6 months). There was no significant difference in the overall mean recurrent instability rate between the LD and BC groups (4.9% ± 3.6% vs 4.4% ± 5.1%, respectively; P = .83), with similar results in a subanalysis of studies utilizing only suture anchor fixation (4.9% ± 3.6% vs 3.2% ± 5.6%, respectively; P = .54). There was no significant difference in the return-to-sport rate between the BC and LD groups (96.2% ± 5.4% vs 88.6% ± 9.1%, respectively; P = .30). Range of motion and other patient-reported outcome scores were not provided consistently across studies to allow for statistical comparisons. Conclusion: Low rates of recurrent shoulder instability and high rates of return to sport can be achieved after arthroscopic posterior shoulder stabilization in either the LD or the BC position. Additional long-term randomized trials comparing these positions are needed to better understand the potential advantages and disadvantages of surgical positioning for posterior shoulder stabilization.

scholarly journals Sexual Coercion Risk and Women’s Sport Participation

2013 ◽  
Vol 57 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Elise Brown ◽  
Laura Spiller ◽  
Beverly Stiles ◽  
Lon Kilgore
Keyword(s):  
Alcohol Use ◽  
Sexual Coercion ◽  
Sport Participation ◽  
Female Athletes ◽  
Self Esteem ◽  
Sexual Partners ◽  
Sexual Assertiveness ◽  
Higher Alcohol ◽  
Significant Difference ◽  
Number Of Sexual Partners

Abstract Sexual coercion affects approximately 58% of college-age females. Victims of sexual coercion often share similar characteristics, such as lower self-esteem, lower assertiveness, higher depressive symptoms, higher alcohol use, increased number of sexual partners, more romantic relationships, prior victimization, and relationship insecurity. Female athletes, on the other hand, have in common such protective factors as higher self-esteem, higher assertiveness, lower alcohol use, and fewer sexual partners. These, then, are assumed to guard against sexual coercion. The purpose of this study was to determine if female athletes were at a lower risk for sexual coercion and whether differences existed in levels of assertiveness, sexual assertiveness, self-esteem, sexual esteem, alcohol use, and the number of sexual partners. Participants included 174 college females (aged 19.94 ± 1.87 years). Participants were identified as an athlete if they reported a history of at least three years of athl iation etic involvement and described themselves as either a high school athlete or having participated in competitive sports (n=125). From among all the participants, 49 were classified as non-athletes. Data demonstrated no differences in either forced or coerced sexual contact history. Athletes and nonathletes differed neither in global nor sexual self-esteem, nor did they differ in global or sexual assertiveness. There was a significant difference across the groups in alcohol use: athletes scored higher on the AUDIT than non-athletes. The number of years of sport involvement positively correlated with the level of alcohol use. Athletes and non-athletes reported similar numbers of sexual partners. The findings of this study imply that athletics may indirectly place females at risk for sexual coercion through an assocwith higher alcohol use.

scholarly journals Short uncemented femoral component for hip revision: prognosis and risk factors associated with failure

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeming Liu ◽  
Bo Liu ◽  
Bingshi Zhang ◽  
Wenhui Ma ◽  
Tao Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survival Rate ◽  
Femoral Component ◽  
Revision Surgery ◽  
Femoral Fracture ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Categorical Variables ◽  
Periprosthetic Femoral Fracture ◽  
Significant Difference

Abstract Background The application of short femoral stems is partially restricted in revision surgery. This study will demonstrate the therapeutic effect and unsuitable situation for short stem revision. Methods Demographic characteristics of all patients were recorded in detail (Table 1). Anteroposterior view radiographic examinations of proximal femur are necessary before and after the operation for patients. The primary outcome of interest was the survival rate of the femoral stem at the final follow-up. Risk factors for failure were also investigated. The secondary outcomes of interest included the Harris hip score, excellent to good rate and incidence of complications. The Mann–Whitney U test was performed for comparisons between continuous variables. The chi-square test was performed for comparisons between categorical variables. Cox regression analysis was used to assess the association between potential risk factors and the failure of revision surgery. Results A total of 381 patients with short stems were retrospectively reviewed. There were 188 males and 193 females. The average age and body mass index before revision surgery were 58.85 ± 13.46 years and 23.72 ± 3.40 kg/m2, respectively. The mid-term survival rate of the short femoral component was 94.23%. The prognosis and complications of patients between the two groups were compared. There was no significant difference between the two groups in the Harris score, complication incidence or survival rate of the femoral component. The strongest risk factor in this study was intraoperative periprosthetic femoral fracture during revision surgery (HR = 5.477, 95% CI = 2.156–13.913). Conclusion Three risk factors for failure were identified: ageing, osteoporosis and intraoperative periprosthetic femoral fracture during revision surgery. Therefore, a short femoral stem should be implanted in patients with these risk factors with additional caution.

scholarly journals The Preventable Shunt Revision Rate: a potential quality metric for pediatric shunt surgery

2016 ◽  
Vol 18 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Garrett T. Venable ◽  
Nicholas B. Rossi ◽  
G. Morgan Jones ◽  
Nickalus R. Khan ◽  
Zachary S. Smalley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Operating Room ◽  
Revision Surgery ◽  
Revision Rate ◽  
Catheter Placement ◽  
Shunt Revision ◽  
Shunt Failure ◽  
Shunt Surgery ◽  
Distal Catheter ◽  
Quality Metric

OBJECTIVE Shunt surgery consumes a large amount of pediatric neurosurgical health care resources. Although many studies have sought to identify risk factors for shunt failure, there is no consensus within the literature on variables that are predictive or protective. In this era of “quality outcome measures,” some authors have proposed various metrics to assess quality outcomes for shunt surgery. In this paper, the Preventable Shunt Revision Rate (PSRR) is proposed as a novel quality metric. METHODS An institutional shunt database was queried to identify all shunt surgeries performed from January 1, 2010, to December 31, 2014, at Le Bonheur Children's Hospital. Patients' records were reviewed for 90 days following each “index” shunt surgery to identify those patients who required a return to the operating room. Clinical, demographic, and radiological factors were reviewed for each index operation, and each failure was analyzed for potentially preventable causes. RESULTS During the study period, there were 927 de novo or revision shunt operations in 525 patients. A return to the operating room occurred 202 times within 90 days of shunt surgery in 927 index surgeries (21.8%). In 67 cases (33% of failures), the revision surgery was due to potentially preventable causes, defined as inaccurate proximal or distal catheter placement, infection, or inadequately secured or assembled shunt apparatus. Comparing cases in which failure was due to preventable causes and those in which it was due to nonpreventable causes showed that in cases in which failure was due to preventable causes, the patients were significantly younger (median 3.1 vs 6.7 years, p = 0.01) and the failure was more likely to occur within 30 days of the index surgery (80.6% vs 64.4% of cases, p = 0.02). The most common causes of preventable shunt failure were inaccurate proximal catheter placement (33 [49.3%] of 67 cases) and infection (28 [41.8%] of 67 cases). No variables were found to be predictive of preventable shunt failure with multivariate logistic regression. CONCLUSIONS With economic and governmental pressures to identify and implement “quality measures” for shunt surgery, pediatric neurosurgeons and hospital administrators must be careful to avoid linking all shunt revisions with “poor” or less-than-optimal quality care. To date, many of the purported risk factors for shunt failure and causes of shunt revision surgery are beyond the influence and control of the surgeon. We propose the PSRR as a specific, meaningful, measurable, and—hopefully—modifiable quality metric for shunt surgery in children.

scholarly journals Risk Factors for Revision of Posterior Shoulder Stabilization in Throwing Athletes

2021 ◽  
Vol 37 (1) ◽  
pp. e13
Author(s):  
Ravi S. Vaswani ◽  
Justin Arner ◽  
Halle Freiman ◽  
James Bradley
Keyword(s):  
Risk Factors ◽  
Shoulder Stabilization ◽  
Posterior Shoulder

scholarly journals The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability

Joints ◽  
2021 ◽  
Author(s):  
Alberto Vascellari ◽  
Carlo Ramponi ◽  
Davide Venturin ◽  
Giulia Ben ◽  
Nicolò Coletti
Keyword(s):  
Sport Participation ◽  
Case Series ◽  
Return To Sport ◽  
Shoulder Function ◽  
Retrospective Case ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The Difference ◽  
The Relationship

Abstract Purpose To evaluate the relationship between kinesiophobia and patient's return to sport after shoulder stabilization surgery. The hypothesis was that kinesiophobia represents an independent factor correlated to the difference between preinjury and postoperative level of sport. Methods This study retrospectively evaluated 66 patients (mean age: 35.5, standard deviation [SD] = 9.9 years) and at a mean follow-up of 61.1 (SD = 37.5) months after arthroscopic Bankart's repair or open Bristow–Latarjet procedure. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK); return to the preinjury sport was assessed by the difference between baseline and postoperative degree of shoulder involvement in sport (D-DOSIS) scale. The Western Ontario Shoulder Instability index (WOSI) was used to evaluate participants' perceptions of shoulder function. Results TSK showed correlation with D-DOSIS (ρ = 0.505, p < 0.001) and the WOSI score (ρ = 0.589, p < 0.001). There was significant difference in TSK and WOSI scores between participants who had and had not returned to their previous level of sport participation (p = 0.006, and 0.0001, respectively). Conclusion This study demonstrated that kinesiophobia is correlated to the return to sport after shoulder stabilization surgery. Level of Evidence Level IV, retrospective case series.

scholarly journals Motivation for Participation in Sports Based on Athletes in Team and Individual Sports

2020 ◽  
Vol 85 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Jalil Moradi ◽  
Alireza Bahrami ◽  
Amir Dana
Keyword(s):  
Physical Activity ◽  
Sport Participation ◽  
Female Athletes ◽  
Sports Participation ◽  
T Test ◽  
Male And Female ◽  
Kung Fu ◽  
Participation Motivation ◽  
Significant Difference ◽  
Individual Sports

AbstractThere are many reasons why individuals are motivated to participate in sports. For athletes to participate in and keep up exercise, investigating the participation motivation of athletes is necessary. The aim of this study was to compare sport participation motivation of athletes in team and individual disciplines. The sample consisted of 265 athletes including four teams from football, volleyball, basketball, and handball and two individual disciplines of kung fu and taekwondo which were randomly selected. The 30-item sports participation motivation questionnaire (PMQ) was used. Analysis of data was conducted by the use of independent-samples t-test. The results showed that there is a significant difference between the sports participation motivation of athletes in a team and individual sports as well as between male and female athletes. But, among the components of the sports participation motivation, only the aspect of achievement in a team and individual sports and the aspect of finding friendship in male and female athletes existed, no other significant difference was observed. The results of this study show that sports discipline and the athlete’s gender is effective in motivating athletes’ continuation and commitment to a physical activity.

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