153: Dr. Sara Edwards – The Thrower’s Shoulder (Part 2)

The Sports Docs Podcast

Our conversation picks back up with an article titled “Patient Outcomes and Return to Play After Arthroscopic Rotator Cuff Repair in Overhead Athletes.” This systematic review, published in the January 2023 issue of JOT, analyzed 20 studies comprising 692 patients with an average follow-up of 40 months. The authors found that arthroscopic cuff repair led to significant improvements in patient reported outcomes as well as improved shoulder elevation. Overall, 75% of athletes returned to play at a mean of 6.4 months post-op, and 63% returned to their preinjury level of sport. Complication and reoperation rates were relatively low at 7% and 10%, respectively.

Then, from the December 2019 issue of AJSM, we review an article titled “Partial-Thickness Rotator Cuff Tear by Itself Does Not Cause Shoulder Pain or Muscle Weakness in Baseball Players.” This cross-sectional study investigated whether articular-sided partial-thickness rotator cuff tears alone produce symptoms in overhead athletes. Of the 87 collegiate baseball players that were analyzed, 47% had ultrasound-confirmed partial-thickness tears, yet rates of shoulder pain and muscle weakness were not significantly different from those without tears. Most of these tears were small (approximately 5 mm in depth) and were asymptomatic in 83%. Pain correlated instead with scapular malposition, dyskinesis, and poor total shoulder condition – not the presence of a tear.

We finish up our discussion today with an article titled “Internal impingement of the shoulder in overhead athletes: Retrospective multicenter study in 135 arthroscopically-treated patients.” Patients underwent a variety of procedures, including cuff debridement or repair, posterior glenoidplasty, labral debridement, posterior capsular release, and anterior capsulorrhaphy. Overall, 90% returned to sports, with 52% returning to their prior level at an average of 9 months. Better return-to-sport outcomes were associated with male sex, presence of a cuff lesion, and simple cuff debridement. Greater tuberosity cysts and anterior capsulorrhaphy correlated with poorer outcomes and higher post-op pain.

We hope you enjoy this episode!