Benvegnu Neilen A, Gnandt Ryan, Nammour Michael, Patel Neel, Schulz William, Eads Ryan, Vyas Dharmesh
University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Mayo Clinic Health System, Rochester, Minnesota, USA.
Orthop J Sports Med. 2024 Dec 12;12(12):23259671241271704. doi: 10.1177/23259671241271704. eCollection 2024 Dec.
Managing an in-season anterior shoulder instability poses a special challenge for team physicians, as they need to balance the aim of promptly returning the athlete to play while mitigating the chances of recurrence and further injury to the shoulder.
To investigate and report on the treatment preferences of National Hockey League (NHL) team physicians when managing in-season first-time anterior shoulder instability in professional hockey players.
Cross-sectional study.
A survey consisting of 33 sport-specific questions focused on the treatment options and preferences for anterior shoulder instability in hockey players was developed, and 32 NHL team physicians were invited to anonymously complete the survey. Following the collection of the data, the distribution of the responses to each question was documented as counts and percentages.
Of the 32 invited team physicians, 31 (97%) completed all (n = 28) or most (n = 3) of the survey. The mean experience of the respondents was 13 ± 11 years. A total of 28 (90%) respondents would attempt nonoperative treatment of an in-season initial anterior shoulder dislocation with an isolated soft tissue injury, while 28 (90%) would recommend operative treatment of the same injury with bony involvement. Of the 31 respondents, 30 (97%) utilized rehabilitation parameters rather than time from injury when determining whether a player could return to play. Of those parameters, clinical strength (100%), range of motion (87%), anterior apprehension (84%), and pain (65%) were the most utilized. For surgical management of an isolated soft tissue lesion, 28 (90%) of the respondents preferred arthroscopic repair, while 2 (7%) preferred open repair.
Of the 32 NHL team physicians surveyed, 28 preferred nonoperative management for the treatment of initial anterior shoulder dislocations with isolated soft tissue injuries, while initial operative management was preferred by the same number of team physicians for any injuries with bony involvement.
在赛季中处理前肩不稳对队医来说是一项特殊挑战，因为他们需要在促使运动员迅速重返赛场的目标与降低复发几率及肩部进一步受伤风险之间取得平衡。
调查并报告国家冰球联盟（NHL）队医在处理职业冰球运动员赛季中首次前肩不稳时的治疗偏好。
横断面研究。
制定了一份包含33个针对特定运动项目问题的调查问卷，重点关注冰球运动员前肩不稳的治疗选择和偏好，并邀请32名NHL队医匿名完成该调查。收集数据后，记录每个问题的回答分布情况，以计数和百分比形式呈现。
在32名受邀队医中，31名（97%）完成了全部（n = 28）或大部分（n = 3）调查。受访者的平均经验为13 ± 11年。共有28名（90%）受访者会尝试对赛季中首次出现的伴有孤立软组织损伤的前肩脱位进行非手术治疗，而28名（90%）受访者会建议对伴有骨质损伤的相同损伤进行手术治疗。在31名受访者中，30名（97%）在确定运动员是否可以重返赛场时采用康复参数而非受伤时间。在这些参数中，临床力量（100%）、活动范围（87%）、前向恐惧（84%）和疼痛（65%）是最常使用的。对于孤立软组织损伤的手术治疗，28名（90%）受访者更倾向于关节镜修复，而2名（7%）受访者更倾向于开放修复。
在接受调查的32名NHL队医中，28名更倾向于对伴有孤立软组织损伤的首次前肩脱位进行非手术治疗，而对于伴有骨质损伤的任何损伤，相同数量的队医更倾向于首次进行手术治疗。
