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Return to Competition in Elite Judo Athletes After Arthroscopic Soft Tissue Stabilization With Selective Augmentation
Hiroshige Hamada1,2, Hiroyuki Sugaya1, Norimasa Takahashi2
1Tokyo Sports and Orthopaedic Clinic, Toshima, Tokyo, Japan.
Background:
Shoulder instability is one of the most common problems in judo. Some studies have examined outcomes of shoulder stabilization in judo athletes. While open procedures yield acceptable results, arthroscopic stabilization has yielded poor outcomes or involved small sample sizes. For >20 years, the authors have treated competitive judo athletes with soft tissue Bankart repair and soft tissue augmentation, such as rotator interval closure.
Purpose:
To present the results of a treatment algorithm for arthroscopic soft tissue stabilization with selective augmentation in competitive judo athletes, with special emphasis on the risk of recurrence, range of motion restrictions, and return-to-sport outcomes.
Study Design:
Case series; Level of evidence, 4.
Methods:
Competitive judo athletes who underwent arthroscopic soft tissue shoulder stabilization for recurrent traumatic anterior shoulder instability between August 2004 and December 2015 were included. Patients with <2 years of follow-up were excluded. All procedures were performed according to the treatment algorithm. Outcomes assessed included recurrence, return to sport, range of motion, Rowe score, and Subjective Shoulder Value for sports (SSV-sports).
Results:
A total of 84 shoulders in 78 competitive judo athletes (58 male, 20 female; mean age at surgery, 19 years) were included. Among them, 6 athletes (4 male, 2 female) underwent bilateral surgery, resulting in 62 shoulders from male athletes and 22 shoulders from female athletes. The mean follow-up was 65 months (range, 24-166 months). All procedures were performed according to the treatment algorithm. The overall recurrence rate was 4.8% (4/84 shoulders), and all recurrences occurred in the tsurite group. The mean loss in abduction-external rotation was observed but did not affect return to sport. Among the 74 patients without recurrence, 69 (93%) returned to the same or higher preinjury competition level. The Rowe and SSV-sports scores were significantly improved postoperatively.
Conclusion:
The treatment algorithm for arthroscopic soft tissue shoulder stabilization in competitive judo athletes resulted in good clinical outcomes, with low recurrence rates and a high rate of return to preinjury levels in tsurite- as well as hikite-side shoulders.
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