Joint position awareness and sports activity after capsulolabral reconstruction in the overhead athlete

A total of 24 overhead athletes with posttraumatic, chronic anterior shoulder instability underwent surgery. Twenty-two patients were examined after an average follow-up of 2.8 +/- 0.7 years. On average, a Constant-Score and Constant-Murley-Score of 93.7 +/- 5.3 points and an ASES-Score of 95.0 +/- 5.1 points were achieved. The redislocation rate was 9 %. The study demonstrated, that despite the good clinical results, only 12 out of 22 (55 %) of patients were able to return to their previous sports activity level. This relevant problem is in agreement with other similar studies [ ], so it was further addressed by determination of joint position awareness (JPA) and electromyographic muscle activity. Postoperatively, a persisting deficit of JPA, as well as an altered EMG pattern, was found with a significant reduction in activity of the deltoideus muscle on the operated side. The analysis of the data of each patient showed that there was a significant relation between the restitution of JPA and ability to return to the previous sports activity level. In contrast, the relation between EMG pattern and full recovery to completely unrestricted shoulder function was not significant. The anterior capsulolabral reconstruction enables a reliable restoration of shoulder stability and a low rate of complications. The problem that a relatively high percentage of overhead athletes can not return to their previous performance level is based on an impaired joint position awareness.