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关节镜和开放性肩部手术后恢复射击的速率和时间。

Rate and time to return to shooting following arthroscopic and open shoulder surgery.

作者信息

Galvin Joseph W, Slevin John, Yu Henry H, Turner Eric K, Tokish John M, Grassbaugh Jason A, Arrington Edward D

机构信息

Department of Orthopedic Surgery, Madigan Army Medical Center, Tacoma, WA, USA.

Department of Orthopedic Surgery, Mayo Clinic-Arizona, Phoenix, AZ, USA.

出版信息

JSES Int. 2022 Aug 12;6(6):963-969. doi: 10.1016/j.jseint.2022.07.010. eCollection 2022 Nov.

Abstract

BACKGROUND

There is limited information on return to shooting following shoulder surgery. The purpose of this study is to determine the rate and timing for resuming shooting a rifle following shoulder surgery.

METHODS

We performed a retrospective review of prospectively collected data. The study included patients undergoing arthroscopic and open shoulder stabilization for unidirectional shoulder instability, and arthroscopic surgery for rotator cuff tears, SLAP lesions, biceps tendinopathy, and acromioclavicular pathology. Data collected included the laterality of surgery, shooting dominance, and patient-reported outcome measures at the preoperative and postoperative visits. Starting at the 4.5-month clinic visit, patients were asked if they could shoot a military rifle.

RESULTS

One hundred patients were identified with arthroscopic and open shoulder surgery with a mean age of 30 years (range, 18-45) and a mean follow-up of 24 months (range, 12-32). The cohort consisted of patients undergoing arthroscopic Bankart repair (n = 23), arthroscopic posterior labral repair (n = 18), open Latarjet (n = 16), mini-open subpectoral biceps tenodesis (OBT) (n = 25), OBT with open distal clavicle resection (DCR) (n = 10), open DCR (n = 4), and arthroscopic rotator cuff repair with concomitant OBT (n = 4). Significant improvement in SSV, VAS, ASES, and WOSI was shown at 1-year postoperative, SSV 85, VAS 2, ASES 85, WOSI 239,  = .001. The percentage of patients reporting the ability to shoot a military rifle postoperatively were 47%, 63%, 85%, and 94% at 4.5 months, 6 months, 1 year, and 2 years, respectively. At 4.5 months postoperatively, patients who underwent surgery ipsilateral to their shooting dominance (n = 59) had a rate of return to shooting (33%) versus shoulder surgery on the contralateral side of shooting dominance (n = 41) (60%),  = .04. However, there was no significant difference in the groups at 6 months and 1 year. Additionally, there was a significant difference in the rate of return to shooting at 6 months in patients undergoing arthroscopic posterior labral repair versus the remainder of the cohort (posterior instability (33%) vs. (69%),  = .016), and a significant difference between posterior shoulder stabilization and anterior shoulder stabilization (70%),  = .03.

CONCLUSION

Patients undergoing arthroscopic and open shoulder surgery have a high rate of return to shooting. Approximately 60% of patients resume shooting at 6 months postoperatively and 85% return at 1 year. Patients undergoing shoulder surgery on the contralateral side of their shooting dominance return to shooting significantly faster than those with shoulder surgery ipsilateral to their shooting dominance. Additionally, those undergoing arthroscopic posterior shoulder stabilization return to shooting at a slower rate than anterior stabilization surgery.

摘要

背景

关于肩部手术后恢复射击的信息有限。本研究的目的是确定肩部手术后恢复步枪射击的比率和时间。

方法

我们对前瞻性收集的数据进行了回顾性分析。该研究纳入了因单向肩部不稳接受关节镜和开放性肩部稳定手术的患者,以及因肩袖撕裂、SLAP损伤、肱二头肌肌腱病和肩锁关节病变接受关节镜手术的患者。收集的数据包括手术部位、射击优势手,以及术前和术后访视时患者报告的结果指标。从术后4.5个月的门诊访视开始,询问患者是否能够射击军用步枪。

结果

共确定100例接受关节镜和开放性肩部手术的患者,平均年龄30岁(范围18 - 45岁),平均随访24个月(范围12 - 32个月)。该队列包括接受关节镜下Bankart修复术的患者(n = 23)、关节镜下后侧盂唇修复术的患者(n = 18)、开放性Latarjet手术的患者(n = 16)、小切口胸小肌下肱二头肌肌腱固定术(OBT)的患者(n = 25)、OBT联合开放性锁骨远端切除术(DCR)的患者(n = 10)、开放性DCR的患者(n = 4),以及关节镜下肩袖修复联合OBT的患者(n = 4)。术后1年时,SSV、VAS、ASES和WOSI有显著改善,SSV为85,VAS为2,ASES为85,WOSI为239,P = 0.001。术后报告能够射击军用步枪的患者百分比在4.5个月、6个月、1年和2年时分别为47%、63%、85%和94%。术后4.5个月时,在射击优势手同侧接受手术的患者(n = 59)恢复射击的比率为33%,而在射击优势手对侧接受肩部手术的患者(n = 41)恢复射击的比率为60%,P = 0.04。然而,在6个月和1年时两组之间无显著差异。此外,接受关节镜下后侧盂唇修复术的患者在6个月时恢复射击的比率与队列其余患者有显著差异(后侧不稳患者为33%,其余患者为69%,P = 0.016),并且后侧肩部稳定手术与前侧肩部稳定手术之间存在显著差异(70%,P = 0.03)。

结论

接受关节镜和开放性肩部手术的患者恢复射击的比率较高。约60%的患者在术后6个月恢复射击,85%的患者在1年时恢复射击。在射击优势手对侧接受肩部手术的患者恢复射击的速度明显快于在射击优势手同侧接受肩部手术的患者。此外,接受关节镜下后侧肩部稳定手术的患者恢复射击的速度比前侧稳定手术慢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e427/9637676/b584704d0eea/gr1.jpg

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