Department of Sporttraumatology, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, Frankfurt am Main, Germany.
Am J Sports Med. 2011 Nov;39(11):2404-14. doi: 10.1177/0363546511417407. Epub 2011 Aug 31.
Reports of return to shoulder-dependent sport after surgical stabilization previously underestimated impairments, which were not reflected in the score systems used.
Return to shoulder-dependent sport depends on the type of sport performed.
Case series; Level of evidence, 4.
Forty-seven athletes (26.9 years of age at surgery) who underwent isolated arthroscopic Bankart repair were longitudinally monitored by shoulder-dependent sport-specific activity (Shoulder Sport Activity Score [SSAS]) and ability (Athletic Shoulder Outcome Scoring System [ASOSS]) scores and visual analog scales for reachieved proficiency level, sport-specific shoulder pain, and functional deficits. Data were assessed at 4 points of treatment: preoperatively, and postoperatively after 6, 16, and 32 months (P0-P3). Athletes were analyzed separately according to shoulder sport: noncollision/nonoverhead (G1), collision (G2), overhead (G3), and martial arts (G4).
The G1 and G2 athletes had re-achieved the preinjury sport activity and sport proficiency status and excellent ASOSS scores after 32 months (SSAS(G1) = 7.2, SSAS(G2) = 8.1, ASOSS(G1) = 94.4, ASOSS(G2) = 95.2), whereas G3 and G4 athletes remained at an inferior activity level (SSAS(G3) = 8.0, SSAS(G4) = 8.3) and proficiency level. The ASOSS documented a prolonged period of shoulder rehabilitation for G3 and G4 athletes to reach a good shoulder-dependent sport ability outcome after 32 months (ASOSS(G3) = 89.0, ASOSS(G4) = 93.1). All groups recorded persisting limitations in visual analog scales for sport-specific shoulder function and pain. The established scores (Rowe = 95.9, Walch-Duplay = 93.3, Constant = 94.0) did not reflect these sport-specific impairments. Athletes with 5 or more preoperative dislocations had significantly longer surgery-to-sport resumption intervals with a prolonged proficiency recovery.
The athletes' shoulder stabilization resulted in a prolonged rehabilitation depending on the functional demand of the performed shoulder-dependent sport, as shown by the specific shoulder sport score systems.
先前的研究报告低估了手术后肩部依赖运动恢复的功能障碍，而这些功能障碍并未反映在使用的评分系统中。
肩部依赖运动的恢复取决于运动的类型。
病例系列；证据水平，4 级。
47 名运动员（手术时 26.9 岁）接受了单独的关节镜 Bankart 修复术，通过肩部依赖运动特定的活动（肩部运动活动评分 [SSAS]）和能力（运动肩结局评分系统 [ASOSS]）评分以及视觉模拟量表来监测，以评估其达到熟练程度的水平、肩部运动相关的疼痛和功能缺陷。数据在治疗的 4 个时间点进行评估：术前，术后 6、16 和 32 个月（P0-P3）。根据肩部运动将运动员分为非碰撞/非过头（G1）、碰撞（G2）、过头（G3）和武术（G4）4 个组进行分析。
G1 和 G2 运动员在 32 个月后恢复了受伤前的运动活动和运动熟练程度，并获得了优异的 ASOSS 评分（SSAS（G1）=7.2，SSAS（G2）=8.1，ASOSS（G1）=94.4，ASOSS（G2）=95.2），而 G3 和 G4 运动员的运动活动和熟练程度仍较低（SSAS（G3）=8.0，SSAS（G4）=8.3）。ASOSS 记录了 G3 和 G4 运动员需要更长的时间来恢复良好的肩部依赖运动能力，在 32 个月后达到较好的结果（ASOSS（G3）=89.0，ASOSS（G4）=93.1）。所有组在视觉模拟量表上仍记录到与肩部运动功能和疼痛相关的运动特异性限制。既定的评分（Rowe=95.9，Walch-Duplay=93.3，Constant=94.0）并未反映这些运动特异性损伤。术前有 5 次或以上脱位的运动员手术至运动恢复的时间间隔明显更长，熟练程度的恢复也更长。
运动员肩部稳定性的恢复取决于所进行的肩部依赖运动的功能需求，这在特定的肩部运动评分系统中得到了体现。
