Knapik Derrick M, Gillespie Robert J, Salata Michael J, Voos James E
University Hospitals Sports Medicine Institute, Cleveland, Ohio, USA.
Orthop J Sports Med. 2017 Aug 9;5(8):2325967117722945. doi: 10.1177/2325967117722945. eCollection 2017 Aug.
Bony augmentation of the anterior glenoid is used in athletes with recurrent shoulder instability and bone loss; however, the prevalence and impact of repair in elite American football athletes are unknown.
To evaluate the prevalence and impact of glenoid augmentation in athletes invited to the National Football League (NFL) Scouting Combine from 2012 to 2015.
Case series; Level of evidence, 4.
A total of 1311 athletes invited to the NFL Combine from 2012 to 2015 were evaluated for history of either Bristow or Latarjet surgery for recurrent anterior shoulder instability. Athlete demographics, surgical history, imaging, and physical examination results were recorded using the NFL Combine database. Prospective participation data with regard to draft status, games played, games started, and status after the athletes' first season in the NFL were gathered using publicly available databases.
Surgical repair was performed on 10 shoulders in 10 athletes (0.76%), with the highest prevalence in defensive backs (30%; n = 3). Deficits in shoulder motion were exhibited in 70% (n = 7) of athletes, while 40% (n = 4) had evidence of mild glenohumeral arthritis and 80% demonstrated imaging findings consistent with a prior instability episode (8 labral tears, 2 Hill-Sachs lesions). Prospectively, 40% (n = 4) of athletes were drafted into the NFL. In the first season after the combine, athletes with a history of glenoid augmentation were not found to be at significant risk for diminished participation with regard to games played or started when compared with athletes with no history of glenoid augmentation or athletes undergoing isolated shoulder soft tissue repair. After the conclusion of the first NFL season, 60% (n = 6 athletes) were on an active NFL roster.
Despite being drafted at a lower rate than their peers, there were no significant limitations in NFL participation for athletes with a history of glenoid augmentation when compared with athletes without a history of shoulder surgery or those with isolated soft tissue shoulder repair. Glenohumeral arthritis and advanced imaging findings of labral tearing and Hill-Sachs lesions in elite American football players with a history of glenoid augmentation did not significantly affect NFL participation 1 year after the combine.
对于复发性肩关节不稳定和骨质流失的运动员,采用前肩胛盂骨增大术;然而,在美国职业橄榄球大联盟(NFL)精英运动员中,该修复术的患病率及影响尚不清楚。
评估2012年至2015年受邀参加NFL选拔大会的运动员中肩胛盂增大术的患病率及影响。
病例系列;证据等级,4级。
对2012年至2015年受邀参加NFL选拔大会的1311名运动员进行评估,了解其因复发性前肩关节不稳定而接受布里斯托或拉塔热手术的病史。使用NFL选拔大会数据库记录运动员的人口统计学信息、手术史、影像学检查和体格检查结果。通过公开可用数据库收集有关选秀状态、比赛场次、首发场次以及运动员在NFL第一个赛季后的状态等前瞻性参赛数据。
10名运动员的10个肩部进行了手术修复(0.76%),其中防守后卫的患病率最高(30%;n = 3)。70%(n = 7)的运动员存在肩部活动度不足,40%(n = 4)有轻度肩肱关节炎的证据,80%的运动员影像学检查结果与既往不稳定发作一致(8例盂唇撕裂,2例希尔-萨克斯损伤)。前瞻性来看,40%(n = 4)的运动员被选入NFL。在选拔大会后的第一个赛季,与无肩胛盂增大术病史的运动员或接受单纯肩部软组织修复的运动员相比,有肩胛盂增大术病史的运动员在比赛场次或首发场次方面未发现参与度明显降低的显著风险。在NFL第一个赛季结束后,60%(n = 6名运动员)仍在NFL现役球员名单中。
尽管与同龄人相比,有肩胛盂增大术病史的运动员被选中的比例较低,但与无肩部手术史或单纯肩部软组织修复的运动员相比,他们在NFL的参与度并无显著限制。有肩胛盂增大术病史的美国职业橄榄球精英运动员中,肩肱关节炎以及盂唇撕裂和希尔-萨克斯损伤的高级影像学检查结果在选拔大会1年后并未显著影响其在NFL的参与度。