Augmentation Plus Stabilization Better for Collision Athletes

New research suggests that combining arthroscopic soft tissue shoulder stabilization with selected augmentation could offer collision athletes good clinical outcomes.

“Many surgeons prefer bony stabilization including Bristow or Latarjet procedures for shoulder instability in collision athletes, even though several potential complications have been reported,” the authors of “Arthroscopic Soft Tissue Stabilization With Selective Augmentations for Traumatic Anterior Shoulder Instability in Competitive Collision Athletes,” published on April 12, 2021 in The American Journal of Sports Medicine, wrote.

“There has been a limited number of studies on the midterm outcomes of arthroscopic soft tissue stabilization for anterior shoulder instability in competitive collision athletes.”

For their study, the researchers retrospectively assessed rugby or American football players less than 40 years old who underwent either arthroscopic Bankart or bony Bankart repair with the addition of rotator interval closure and/or Hill-Sachs remplissage between January 2012 and March 2017.

Data was collected on recurrence, complications, return to sport, and functional scores.

One hundred patients and 113 shoulders were included in the study. The mean age of the patients was 20 years and the mean follow-up period was 44 months (range, 24-72 months).

Rotator interval closure was performed on 36 shoulders in addition to Bankart repair, and rotator interval closure and Hill-Sachs remplissage on 77 shoulders.

Four of 113 shoulders experienced dislocation, but there were no complications. Ninety-three percent of all athletes returned to sport either at or close to preinjury sports activity levels.

The researchers said that the mean Rowe score also significantly improved from 36 (range, 10-75) at pre-surgery to 96 (range, 35-100; p = .003) at post-surgery. The mean Subjective Shoulder Value Sports Score improved after surgery from a mean preoperative score of 22 (range, 0-50) to a postoperative score of 92 (range, 64-100; p = .002).

“Our treatment strategy, where arthroscopic soft tissue stabilization was combined with selected augmentations, provided good clinical outcomes for competitive collision athletes in terms of low rates of recurrence and complication, a high rate of return to sports, and good shoulder function,” they wrote.