Radkowski Christopher A, Chhabra Anikar, Baker Champ L, Tejwani Samir G, Bradley James P
Pittsburgh Bone & Joint Surgeons, 1321 Fifth Avenue, McKeesport, PA 15132, USA.
Am J Sports Med. 2008 Apr;36(4):693-9. doi: 10.1177/0363546508314426.
There are limited studies evaluating arthroscopic treatment of unidirectional posterior shoulder instability in overhead-throwing athletes.
Arthroscopic capsulolabral repair for unidirectional posterior shoulder instability will yield equivalent stability and functional outcomes in the overhead-throwing athlete and nonthrowers.
Cohort study; Level of evidence, 2.
Ninety-eight athletes (107 shoulders) with unidirectional posterior shoulder instability were treated with arthroscopic posterior capsulolabral reconstruction or, rarely, capsular plication alone, as determined by their specific intra-articular lesions. Patients were evaluated prospectively with the American Shoulder and Elbow Surgeons scoring system. Stability, range of motion, strength, pain, and function were assessed preoperatively and postoperatively with standardized subjective scales. Results for 27 dominant shoulders in throwing athletes (25%) were compared with those for 80 shoulders in nonthrowing athletes (75%).
At a mean follow-up of 27 months postoperatively, there were no differences in the American Shoulder and Elbow Surgeons score or scores for stability, range of motion, strength, pain, and function between the throwers and nonthrowers, with both groups showing a significant improvement in all categories (P < .0001). Excellent or good results were achieved in 89% of the throwers and 93% of the nonthrowers. Throwing athletes were less likely to return to their preinjury levels of sport (55%) compared with nonthrowing athletes (71%).
Arthroscopic posterior capsulolabral repair effectively improves stability, range of motion, strength, pain, and function in throwing athletes with unidirectional posterior shoulder instability. Despite similar outcome measures to nonthrowers, throwing athletes are less likely to return to their preinjury levels of sport.
评估关节镜治疗过头投掷运动员单向性肩关节后向不稳的研究有限。
关节镜下关节囊盂唇修复治疗单向性肩关节后向不稳，在过头投掷运动员和非投掷运动员中能产生同等的稳定性和功能结果。
队列研究；证据等级，2级。
98名单向性肩关节后向不稳的运动员（107个肩关节）接受关节镜下后侧关节囊盂唇重建术，或根据其特定关节内损伤情况，极少数情况下仅行关节囊折叠术。采用美国肩肘外科医师评分系统对患者进行前瞻性评估。术前和术后使用标准化主观量表评估稳定性、活动范围、力量、疼痛和功能。将27名投掷运动员的优势肩（25%）的结果与80名非投掷运动员的肩关节（75%）的结果进行比较。
术后平均随访27个月时,投掷运动员和非投掷运动员之间的美国肩肘外科医师评分以及稳定性、活动范围、力量、疼痛和功能评分无差异，两组在所有类别中均有显著改善（P <.0001）。89%的投掷运动员和93%的非投掷运动员获得了优秀或良好的结果。与非投掷运动员（71%）相比，投掷运动员恢复到伤前运动水平的可能性较小（55%）。
关节镜下后侧关节囊盂唇修复术可有效改善单向性肩关节后向不稳的投掷运动员的稳定性、活动范围、力量、疼痛和功能。尽管与非投掷运动员的结果指标相似，但投掷运动员恢复到伤前运动水平的可能性较小。
