Treatment of shoulder instability helps return collegiate athletes to playing field

Athletes who suffer a shoulder instability injury may return to play more successfully after being treated arthroscopically compared to nonoperative treatment, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting.

"Our research highlights that collegiate collision athletes with in-season shoulder instability injuries are more likely to return to sport successfully the following season, if they undergo arthroscopic stabilization compared to nonoperative treatment," said lead author Jon Dickens, MD from Walter Reed National Military Medical Center in Bethesda, MD.

Dickens and his colleagues prospectively followed 39 contact intercollegiate athletes treated nonoperatively or with arthroscopic stabilization in a multicenter observational study. They also evaluated recurrent instability issues following an initial in-season shoulder injury. Data analyzed included sport played, previous instability events, direction of instability, type of instability (subluxation or dislocation), and treatment method (nonoperative vs. arthroscopic). All nonoperatively treated patients underwent an accelerated, standardized rehabilitation program without shoulder immobilization. Successful return to play was evaluated the following competitive season after rehabilitation had been performed.

Ten athletes chose nonoperative treatment with only four returning successfully to play without a recurrent shoulder instability event. Of the 29 shoulders treated surgically, 90 percent were able to successfully return to play without shoulder injury recurrence. The sports the athletes' played included basketball, soccer, lacrosse, rugby, Men's boxing, baseball, football, martial arts and wrestling.

"This study is the largest collection of in-season, NCAA Division I athletes with shoulder instability and provides significant reason to further analyze how shoulder injuries are treated to get players back on the field," said Dickens.

This paper received the AOSSM Fellows Research Award for Clinical Science.