Subscribe to RSS
DOI: 10.1055/s-0031-1298001
Recovery of Rotators Strength after Latarjet Surgery
Publication History
accepted after revision 14 November 2011
Publication Date:
16 May 2012 (online)
Abstract
The purposes of this study were to prospectively determine changes in rotator cuff strength before and after surgical shoulder stabilization by Bristow-Latarjet procedure and to better estimate time needed for rotator cuff strength recovery. 20 patients with recurrent anterior posttraumatic shoulder dislocation underwent internal (IR) and external (ER) rotator isokinetic evaluation before and 3, 6 and 21 months after Bristow-Latarjet surgery. In a seated position with 45° of shoulder abduction in the scapular plane, both shoulders were evaluated concentrically with a Con-Trex® isokinetic dynamometer at 180°∙s − 1, 120°∙s − 1 and 60°∙s − 1. 3 months post-surgery, IR and ER strength of the operated shoulder were significantly lower than before surgery ( − 28±20% for IR, − 17±17% for ER) (P<0.05). At 6 and 21 months post-surgery, IR and ER strength were comparable to strength before surgery; strength recovery is seen at 6 months post-surgery with long-term maintenance at 21 months. Given the weakness 3 months post-surgery, return to sports (including overhead and contact sports) should be discussed, and 6 months post-surgery may be a better point for an athlete to resume practicing sports. Isokinetic rotator cuff strength evaluation appears to be relevant in helping to determine the need of continuing strength rehabilitation. Pre-surgical evaluation contributes to the relevance of later comparisons.
-
References
- 1 Amako M, Imai T, Okamura K. Recovery of shoulder rotational muscle strength after a combined Bankart and modified Bristow procedure. J Shoulder Elbow Surg 2008; 17: 738-743
- 2 Bak K, Wiesler ER, Poehling GG. Consensus statement on shoulder instability. Arthroscopy 2010; 26: 249-255
- 3 Creighton DW, Shrier I, Shultz R, Meeuwisse WH, Matheson GO. Return-to-play in sport: a decision-based model. Clin J Sport Med 2010; 20: 379-385
- 4 Dauty M, Dominique H, Helena A, Charles D. Evolution of the isokinetic torque of shoulder rotators before and after 3 months of shoulder stabilization by the Latarjet technique. [Article in French] Ann Readapt Med Phys 2007; 50: 201-208
- 5 Dodson CC, Cordasco FA. Anterior glenohumeral joint dislocations. Orthop Clin North Am 2008; 39: 507-518 vii
- 6 Edouard P, Beguin L, Fayolle-Minon I, Degache F, Farizon F, Calmels P. Relationship between strength and functional indexes (Rowe and Walch-Duplay scores) after shoulder surgical stabilization by the Latarjet technique. Ann Phys Rehabil Med 2010; 53: 499-510
- 7 Edouard P, Calmels P, Degache F. The effect of gravitational correction on shoulder internal and external rotation strength. Isokinet Exerc Sci 2009; 17: 35-39
- 8 Edouard P, Degache F, Beguin L, Samozino P, Gresta G, Fayolle-Minon I, Farizon F, Calmels P. Rotator cuff strength in recurrent anterior shoulder instability. J Bone Joint Surg Am 2011; 93: 759-765
- 9 Felicetti G, Scarabelli AD, Gastaldi C, Rovati D, Maini M. Isokinetic assessment and mid-term work reincorporation of patients surgically treated with the shoulder Latarjet technique. [Article in Italian] G Ital Med Lav Ergon 2000; 22: 324-327
- 10 Forthomme B, Willems S, Hurlet S, Berger J, Houben G, Croisier J. Shoulder isokinetic profile after Latarjet’s technique. Isokinet Exerc Sci 2005; 13: 71-76
- 11 Gill TJ, Zarins B. Open repairs for the treatment of anterior shoulder instability. Am J Sports Med 2003; 31: 142-153
- 12 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
- 13 Hiemstra LA, Sasyniuk TM, Mohtadi NG, Fick GH. Shoulder strength after open versus arthroscopic stabilization. Am J Sports Med 2008; 36: 861-867
- 14 Hovelius LK, Sandstrom BC, Rosmark DL, Saebo M, Sundgren KH, Malmqvist BG. Long-term results with the Bankart and Bristow-Latarjet procedures: recurrent shoulder instability and arthropathy. J Shoulder Elbow Surg 2001; 10: 445-452
- 15 Levine WN, Flatow EL. The pathophysiology of shoulder instability. Am J Sports Med 2000; 28: 910-917
- 16 Plotnikoff NA, MacIntyre DL. Test-retest reliability of glenohumeral internal and external rotator strength. Clin J Sport Med 2002; 12: 367-372
- 17 Regan Jr WD, Webster-Bogaert S, Hawkins RJ, Fowler PJ. Comparative functional analysis of the Bristow, Magnuson-Stack, and Putti-Platt procedures for recurrent dislocation of the shoulder. Am J Sports Med 1989; 17: 42-48
- 18 Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 1978; 60: 1-16
- 19 Scheibel M, Tsynman A, Magosch P, Schroeder RJ, Habermeyer P. Postoperative subscapularis muscle insufficiency after primary and revision open shoulder stabilization. Am J Sports Med 2006; 34: 1586-1593
- 20 Weaver JK, Derkash RS. Don't forget the Bristow-Latarjet procedure. Clin Orthop Relat Res 1994; 102-110
- 21 Wredmark T, Tornkvist H, Johansson C, Brobert B. Long-term functional results of the modified Bristow procedure for recurrent dislocations of the shoulder. Am J Sports Med 1992; 20: 157-161
- 22 Zapartidis I, Gouvali M, Bayios I, Boudolos K. Throwing effectiveness and rotational strength of the shoulder in team handball. J Sports Med Phys Fitness 2007; 47: 169-178