HSS J. 2010 Sep;6(2):145-9. doi: 10.1007/s11420-009-9153-4. Epub 2010 Jan 28.
Shoulder pain is a common and difficult problem in competitive swimmers due to cumulative loads from repetitive overhead motion. Capsular laxity has been implicated as a potential etiology for shoulder pain in competitive swimmers. No study has examined the role of capsular plication in addressing recurrent shoulder pain in competitive swimmers. The purpose of this study is to retrospectively describe our series of competitive swimmers treated with arthroscopic capsular plication with a primary outcome of return to competitive swimming. Eighteen shoulders in 15 patients underwent arthroscopic capsular plication from 2003 to 2007. Patients were contacted at an average follow-up of 29 months (range, 8-42) and a swimming history, American Shoulder and Elbow (ASES) scores, and L'Insalata scores were obtained. At time of surgery, all patients demonstrated laxity under examination under anesthesia. All patients had a positive drive-through sign. Eighty percent (12/15) of patients returned to competitive swimming although only 20% (3/15) were able to return to their pre-injury training regimen volume. All patients subjectively reported improved pain after surgery. The average ASES score was 78 ± 16 (average, standard deviation). The average L'Insalata score was 82 ± 11. Although our results demonstrate that arthroscopic capsular plication has utility in the treatment of shoulder pain in swimmers who have failed non-operative treatment, the inability of some athletes to return to pre-injury training volume illustrates the difficult nature of shoulder pain in swimmers.
Retrospective case series, Level IV.
本研究旨在回顾性描述我们采用关节镜下囊紧缩术治疗的一组因复发性肩部疼痛而接受治疗的竞技游泳运动员，主要结局指标为重返竞技游泳。
2003 年至 2007 年，15 例患者的 18 个肩部接受了关节镜下囊紧缩术。平均随访 29 个月（范围，8-42 个月）时，通过联系患者获取了游泳史、美国肩肘外科协会（ASES）评分和 L'Insalata 评分。手术时，所有患者在麻醉下检查时均表现出松弛。所有患者的“推门试验”均为阳性。80%（12/15）的患者重返竞技游泳，但只有 20%（3/15）的患者能够恢复到受伤前的训练量。所有患者术后均主诉疼痛改善。平均 ASES 评分为 78±16（平均，标准差）。平均 L'Insalata 评分为 82±11。
尽管关节镜下囊紧缩术对非手术治疗失败的肩部疼痛的游泳运动员具有治疗作用，但一些运动员无法恢复到受伤前的训练量，这表明游泳运动员肩部疼痛的性质较为复杂。
关节镜下囊紧缩术是治疗复发性肩部疼痛的一种可行方法，但在一些运动员中，无法恢复到受伤前的训练量，这表明肩部疼痛的治疗具有挑战性。
肩部疼痛是竞技游泳运动员常见且难以解决的问题，这是由于重复性过头运动导致累积负荷所致。囊松弛已被认为是竞技游泳运动员肩部疼痛的潜在病因。尚无研究探讨囊紧缩术在治疗复发性肩部疼痛中的作用。
