Neer modified inferior capsular shift procedure for recurrent anterior instability of the shoulder in judokas
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Yoshiyasu Uchiyama1, Kazutoshi Hamada, Seiji Miyazaki
1Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan. y-uchi@is.icc.u-tokai.ac.jp
Background:
Little has been written about the operative repair of recurrent anterior instability of the shoulder in a single sport: in this case, Judo.
Purpose:
The clinical efficacy of the Neer modified inferior capsular shift as an open procedure for injured judokas was investigated.
Study Design:
Case series; Level of evidence, 4.
Methods:
Fifty athletes (42 male and 8 female, 52 shoulders) took part in this study. The average age at surgery was 20 years (range, 14-38 years), and the mean follow-up period was 61 months (range, 24-172 months). The operation was performed on 29 tsurité (a lapel grip) shoulders and on 23 hikité (a sleeve grip) shoulders. The 2 grips are functionally and technically different from each other.
Results:
Three cases of shoulder instability (5.8%) recurred after surgery. The average loss of external rotation was 9.6 degrees with the arm at the side and 11.6 degrees with the arm in 90 degrees of abduction. The average Rowe and UCLA scores were 37.3 and 20.8 points preoperatively and 86.7 and 32.4 points at the final follow-up, respectively (P < .05). The return rate to the near-preinjury sports activity levels (>90% recovery: grades 1 and 2) was significantly lower in the tsurité shoulders (48.1%) than in the hikité shoulders (85.7%).
Conclusion:
The overall recovery of more than 90% of preinjury activity levels in judo was 65% after modified inferior capsular shift for traumatic anterior instability of the shoulder. The tsurité shoulder should be treated with minimal restriction limitation in external rotation so that it is not limited postoperatively.
