The Journal of Bone and Joint Surgery (American) 84:711-715 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Surgical Treatment of Traumatic Anterior Shoulder Instability in American Football Players
Michael J. Pagnani, MD and
David C. Dome, MD
Investigation performed at Tennessee Orthopaedic Alliance, Nashville,
Tennessee
Michael J. Pagnani, MD
David C. Dome, MD
Tennessee Orthopaedic Alliance, 2410 Patterson Street, Suite 106,
Nashville, TN 37203
The authors did not receive grants or outside funding in support
of their research or preparation of this manuscript. They did not
receive payments or other benefits or a commitment or agreement
to provide such benefits from a commercial entity. No commercial
entity paid or directed, or agreed to pay or direct, any benefits
to any research fund, foundation, educational institution, or other
charitable or nonprofit organization with which the authors are
affiliated or associated.
A commentary is available with the electronic versions of this article,
on our web site (www.jbjs.org) and on our quarterly CD-ROM (call
our subscription department, at 781-449-9780, to order the CD-ROM).
Background:
American football players have been reported to be at high risk
for postoperative instability after arthroscopic stabilization of
anterior shoulder instability. While some authors have recommended
open methods of stabilization in athletes who play contact sports,
there are few data in the literature showing more favorable results
with use of an open technique. We reviewed the results of an open
technique of anterior shoulder stabilization in fifty-eight American
football players after a minimum of two years of follow-up.
Methods:
Fifty-eight American football players underwent open stabilization
with use of a standardized technique for the treatment of recurrent
anterior shoulder instability. Forty-seven patients had recurrent
dislocations, and the remaining eleven had recurrent subluxations.
The average age of the patients was 18.2 years, and the average
duration of follow-up was thirty-seven months. Patients were evaluated
according to the shoulder scoring system of the American Shoulder
and Elbow Surgeons and with use of the shoulder instability score
described by Rowe and Zarins.
Results:
There were no postoperative dislocations. Postoperative subluxation
occurred in two patients, neither of whom had had a dislocation
prior to the operation. Forward flexion and external rotation returned
to within 5° of those of the contralateral shoulder in forty-nine
patients. The average score according to the system of the American
Shoulder and Elbow Surgeons was 97.0 points, and the average Rowe
and Zarins score was 93.6 points. Fifty-five patients had a good
or excellent result, and fifty-two of the fifty-eight returned to
playing football for at least one year. One patient was forced to
stop playing because of recurrent instability.
Conclusions:
Open stabilization is a predictable method of restoring shoulder
stability in American football players while maintaining a range
of motion approximating that found after arthroscopic stabilization.
Postoperative stability appears to be superior to that reported
after arthroscopic techniques in this population of patients.
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