Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit
Background: The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinat...
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| Veröffentlicht in: | The American journal of sports medicine 2012-11, Vol.40 (11), p.2536-2541 |
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| creator | Van Kleunen, Jonathan P. Tucker, Scott A. Field, Larry D. Savoie, Felix H. |
| description | Background:
The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinatus caused by either internal impingement or tension overload may compromise this return.
Hypothesis:
The rate of return to a level of play similar to or greater than the preinjury level after repair of combined SLAP and infraspinatus injuries will be lower than in previous reports of SLAP repair alone.
Study Design:
Case series; Level of evidence, 4.
Methods:
In the current study, we examined a series of overhead-throwing athletes with diagnoses of both a SLAP tear and a significant (>50%) tear of the infraspinatus tendon who underwent surgical repair of both injuries. We identified 17 high-level baseball players younger than 25 years who underwent simultaneous arthroscopic repairs of a SLAP tear with a standard suture anchor technique and of an infraspinatus tear with either a free polydioxanone (PDS) suture or suture anchor between 2005 and 2008. The postoperative records of all patients were reviewed to determine their ability to return to play and their postoperative level of performance. All patients were then contacted to determine their Kerlan-Jobe Orthopaedic Clinic Overhead Athlete Shoulder and Elbow score and their current sport participation level.
Results:
All 17 patients in the series attempted to return to their prior sport after completion of postoperative rehabilitation. Only 6 patients (35%) were able to return to the same or a superior preinjury level of performance. Five of the remaining 11 patients returned to play at a lower level, either playing the same position or else forced to switch to another position of play because of a decline in throwing velocity. Six patients were unable to return to play. No complications or reoperations occurred in any of the patients following surgery.
Conclusion:
A significant (>50%) tear of the infraspinatus in combination with glenohumeral internal rotation deficit (GIRD) and SLAP tears in the throwing athlete results in a guarded prognosis in return to play at the same level. While the rates of return to play in overhead-throwing athletes with an isolated SLAP tear have historically been encouraging, the prognosis for an athlete with both a SLAP and infraspinatus tear is more guarded. These patients are no |
| doi_str_mv | 10.1177/0363546512459481 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1126591473</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546512459481</sage_id><sourcerecordid>2810437041</sourcerecordid><originalsourceid>FETCH-LOGICAL-c395t-35f3a1254ee87bdc351017f280e25c6c9d24aa70ba878b72df8d372141bcc0d03</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS1ERaeFPStkCSGxIOBH_MhyNEBbaSTQUNaR49zMuErswU5A_Qf92XU0Q6kqsfK9ut85vvZB6DUlHylV6hPhkotSCspKUZWaPkMLKgQrOJfiOVrM42Ken6KzlG4IIVRJ_QKdMk4EVZov0N0Gxil6PAZ86ba7Yg2_ocfXuxj-OL_Fy26EiFdhaJw3owseX_kumrSf2ynhDeyNix_wj_Xy-0NjfJvrHkwCHDp80YMPu2mAaPosz4Y-F5swHgw_Q-esG1-ik870CV4dz3P08-uX69Vlsf52cbVargvLKzEWXHTcUCZKAK2a1nJB86M6pgkwYaWtWlYao0hjtNKNYm2nW64YLWljLWkJP0fvD777GH5NkMZ6cMlC3xsPYUo1pUyKipaKZ_TtE_QmTPPyM1UyxYnWLFPkQNkYUorQ1fvoBhNva0rqOaX6aUpZ8uZoPDUDtA-Cv7Fk4N0RMMmaPv-4ty7946SUFSMyc8WBS2YLj7b738X3eT6l7Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1142730882</pqid></control><display><type>article</type><title>Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit</title><source>MEDLINE</source><source>SAGE Complete</source><source>Alma/SFX Local Collection</source><creator>Van Kleunen, Jonathan P. ; Tucker, Scott A. ; Field, Larry D. ; Savoie, Felix H.</creator><creatorcontrib>Van Kleunen, Jonathan P. ; Tucker, Scott A. ; Field, Larry D. ; Savoie, Felix H.</creatorcontrib><description>Background:
The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinatus caused by either internal impingement or tension overload may compromise this return.
Hypothesis:
The rate of return to a level of play similar to or greater than the preinjury level after repair of combined SLAP and infraspinatus injuries will be lower than in previous reports of SLAP repair alone.
Study Design:
Case series; Level of evidence, 4.
Methods:
In the current study, we examined a series of overhead-throwing athletes with diagnoses of both a SLAP tear and a significant (>50%) tear of the infraspinatus tendon who underwent surgical repair of both injuries. We identified 17 high-level baseball players younger than 25 years who underwent simultaneous arthroscopic repairs of a SLAP tear with a standard suture anchor technique and of an infraspinatus tear with either a free polydioxanone (PDS) suture or suture anchor between 2005 and 2008. The postoperative records of all patients were reviewed to determine their ability to return to play and their postoperative level of performance. All patients were then contacted to determine their Kerlan-Jobe Orthopaedic Clinic Overhead Athlete Shoulder and Elbow score and their current sport participation level.
Results:
All 17 patients in the series attempted to return to their prior sport after completion of postoperative rehabilitation. Only 6 patients (35%) were able to return to the same or a superior preinjury level of performance. Five of the remaining 11 patients returned to play at a lower level, either playing the same position or else forced to switch to another position of play because of a decline in throwing velocity. Six patients were unable to return to play. No complications or reoperations occurred in any of the patients following surgery.
Conclusion:
A significant (>50%) tear of the infraspinatus in combination with glenohumeral internal rotation deficit (GIRD) and SLAP tears in the throwing athlete results in a guarded prognosis in return to play at the same level. While the rates of return to play in overhead-throwing athletes with an isolated SLAP tear have historically been encouraging, the prognosis for an athlete with both a SLAP and infraspinatus tear is more guarded. These patients are not likely to return to their preinjury level of play.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546512459481</identifier><identifier>PMID: 23051783</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Arthroscopy ; Athletes ; Athletic Injuries - surgery ; Baseball - injuries ; Biological and medical sciences ; Diseases of the osteoarticular system ; Humans ; Injuries of the limb. Injuries of the spine ; Juxtaarticular diseases. Extraarticular rhumatism ; Male ; Medical sciences ; Orthopedics ; Recovery of Function ; Return to Work ; Shoulder - surgery ; Shoulder Injuries ; Sports injuries ; Sports medicine ; Tendons ; Traumas. Diseases due to physical agents ; Young Adult</subject><ispartof>The American journal of sports medicine, 2012-11, Vol.40 (11), p.2536-2541</ispartof><rights>2012 The Author(s)</rights><rights>2014 INIST-CNRS</rights><rights>Copyright Sage Publications Ltd. Nov 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c395t-35f3a1254ee87bdc351017f280e25c6c9d24aa70ba878b72df8d372141bcc0d03</citedby><cites>FETCH-LOGICAL-c395t-35f3a1254ee87bdc351017f280e25c6c9d24aa70ba878b72df8d372141bcc0d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546512459481$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546512459481$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26669206$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23051783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Kleunen, Jonathan P.</creatorcontrib><creatorcontrib>Tucker, Scott A.</creatorcontrib><creatorcontrib>Field, Larry D.</creatorcontrib><creatorcontrib>Savoie, Felix H.</creatorcontrib><title>Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinatus caused by either internal impingement or tension overload may compromise this return.
Hypothesis:
The rate of return to a level of play similar to or greater than the preinjury level after repair of combined SLAP and infraspinatus injuries will be lower than in previous reports of SLAP repair alone.
Study Design:
Case series; Level of evidence, 4.
Methods:
In the current study, we examined a series of overhead-throwing athletes with diagnoses of both a SLAP tear and a significant (>50%) tear of the infraspinatus tendon who underwent surgical repair of both injuries. We identified 17 high-level baseball players younger than 25 years who underwent simultaneous arthroscopic repairs of a SLAP tear with a standard suture anchor technique and of an infraspinatus tear with either a free polydioxanone (PDS) suture or suture anchor between 2005 and 2008. The postoperative records of all patients were reviewed to determine their ability to return to play and their postoperative level of performance. All patients were then contacted to determine their Kerlan-Jobe Orthopaedic Clinic Overhead Athlete Shoulder and Elbow score and their current sport participation level.
Results:
All 17 patients in the series attempted to return to their prior sport after completion of postoperative rehabilitation. Only 6 patients (35%) were able to return to the same or a superior preinjury level of performance. Five of the remaining 11 patients returned to play at a lower level, either playing the same position or else forced to switch to another position of play because of a decline in throwing velocity. Six patients were unable to return to play. No complications or reoperations occurred in any of the patients following surgery.
Conclusion:
A significant (>50%) tear of the infraspinatus in combination with glenohumeral internal rotation deficit (GIRD) and SLAP tears in the throwing athlete results in a guarded prognosis in return to play at the same level. While the rates of return to play in overhead-throwing athletes with an isolated SLAP tear have historically been encouraging, the prognosis for an athlete with both a SLAP and infraspinatus tear is more guarded. These patients are not likely to return to their preinjury level of play.</description><subject>Adolescent</subject><subject>Arthroscopy</subject><subject>Athletes</subject><subject>Athletic Injuries - surgery</subject><subject>Baseball - injuries</subject><subject>Biological and medical sciences</subject><subject>Diseases of the osteoarticular system</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Juxtaarticular diseases. Extraarticular rhumatism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Orthopedics</subject><subject>Recovery of Function</subject><subject>Return to Work</subject><subject>Shoulder - surgery</subject><subject>Shoulder Injuries</subject><subject>Sports injuries</subject><subject>Sports medicine</subject><subject>Tendons</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtv1DAUhS1ERaeFPStkCSGxIOBH_MhyNEBbaSTQUNaR49zMuErswU5A_Qf92XU0Q6kqsfK9ut85vvZB6DUlHylV6hPhkotSCspKUZWaPkMLKgQrOJfiOVrM42Ken6KzlG4IIVRJ_QKdMk4EVZov0N0Gxil6PAZ86ba7Yg2_ocfXuxj-OL_Fy26EiFdhaJw3owseX_kumrSf2ynhDeyNix_wj_Xy-0NjfJvrHkwCHDp80YMPu2mAaPosz4Y-F5swHgw_Q-esG1-ik870CV4dz3P08-uX69Vlsf52cbVargvLKzEWXHTcUCZKAK2a1nJB86M6pgkwYaWtWlYao0hjtNKNYm2nW64YLWljLWkJP0fvD777GH5NkMZ6cMlC3xsPYUo1pUyKipaKZ_TtE_QmTPPyM1UyxYnWLFPkQNkYUorQ1fvoBhNva0rqOaX6aUpZ8uZoPDUDtA-Cv7Fk4N0RMMmaPv-4ty7946SUFSMyc8WBS2YLj7b738X3eT6l7Q</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Van Kleunen, Jonathan P.</creator><creator>Tucker, Scott A.</creator><creator>Field, Larry D.</creator><creator>Savoie, Felix H.</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20121101</creationdate><title>Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit</title><author>Van Kleunen, Jonathan P. ; Tucker, Scott A. ; Field, Larry D. ; Savoie, Felix H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-35f3a1254ee87bdc351017f280e25c6c9d24aa70ba878b72df8d372141bcc0d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Arthroscopy</topic><topic>Athletes</topic><topic>Athletic Injuries - surgery</topic><topic>Baseball - injuries</topic><topic>Biological and medical sciences</topic><topic>Diseases of the osteoarticular system</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Juxtaarticular diseases. Extraarticular rhumatism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Orthopedics</topic><topic>Recovery of Function</topic><topic>Return to Work</topic><topic>Shoulder - surgery</topic><topic>Shoulder Injuries</topic><topic>Sports injuries</topic><topic>Sports medicine</topic><topic>Tendons</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Kleunen, Jonathan P.</creatorcontrib><creatorcontrib>Tucker, Scott A.</creatorcontrib><creatorcontrib>Field, Larry D.</creatorcontrib><creatorcontrib>Savoie, Felix H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Kleunen, Jonathan P.</au><au>Tucker, Scott A.</au><au>Field, Larry D.</au><au>Savoie, Felix H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>40</volume><issue>11</issue><spage>2536</spage><epage>2541</epage><pages>2536-2541</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background:
The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinatus caused by either internal impingement or tension overload may compromise this return.
Hypothesis:
The rate of return to a level of play similar to or greater than the preinjury level after repair of combined SLAP and infraspinatus injuries will be lower than in previous reports of SLAP repair alone.
Study Design:
Case series; Level of evidence, 4.
Methods:
In the current study, we examined a series of overhead-throwing athletes with diagnoses of both a SLAP tear and a significant (>50%) tear of the infraspinatus tendon who underwent surgical repair of both injuries. We identified 17 high-level baseball players younger than 25 years who underwent simultaneous arthroscopic repairs of a SLAP tear with a standard suture anchor technique and of an infraspinatus tear with either a free polydioxanone (PDS) suture or suture anchor between 2005 and 2008. The postoperative records of all patients were reviewed to determine their ability to return to play and their postoperative level of performance. All patients were then contacted to determine their Kerlan-Jobe Orthopaedic Clinic Overhead Athlete Shoulder and Elbow score and their current sport participation level.
Results:
All 17 patients in the series attempted to return to their prior sport after completion of postoperative rehabilitation. Only 6 patients (35%) were able to return to the same or a superior preinjury level of performance. Five of the remaining 11 patients returned to play at a lower level, either playing the same position or else forced to switch to another position of play because of a decline in throwing velocity. Six patients were unable to return to play. No complications or reoperations occurred in any of the patients following surgery.
Conclusion:
A significant (>50%) tear of the infraspinatus in combination with glenohumeral internal rotation deficit (GIRD) and SLAP tears in the throwing athlete results in a guarded prognosis in return to play at the same level. While the rates of return to play in overhead-throwing athletes with an isolated SLAP tear have historically been encouraging, the prognosis for an athlete with both a SLAP and infraspinatus tear is more guarded. These patients are not likely to return to their preinjury level of play.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>23051783</pmid><doi>10.1177/0363546512459481</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2012-11, Vol.40 (11), p.2536-2541 |
| issn | 0363-5465 1552-3365 |
| language | eng |
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| source | MEDLINE; SAGE Complete; Alma/SFX Local Collection |
| subjects | Adolescent Arthroscopy Athletes Athletic Injuries - surgery Baseball - injuries Biological and medical sciences Diseases of the osteoarticular system Humans Injuries of the limb. Injuries of the spine Juxtaarticular diseases. Extraarticular rhumatism Male Medical sciences Orthopedics Recovery of Function Return to Work Shoulder - surgery Shoulder Injuries Sports injuries Sports medicine Tendons Traumas. Diseases due to physical agents Young Adult |
| title | Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit |
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