Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

Abstract

Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases). In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus) tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms.

Figure 1

Sports activity. Cause of sports activity was 16 being baseball players, 6 volleyball players, 1 handball player, 1 badminton player, and 1 tennis player.

Figure 2

Tear characteristic. (a) Tear characteristic schema. C; concealed tear, A; anterior tear, L; longitudinal tear, T; transverse tear. (b) Concealed tear was found in 10 cases. Complete tear was found in 15 cases; longitudinal tear was found in 13 cases, anterior tear was found in one case, and transverse tear was found in one case.

Figure 3

Injured tendon. ISP tendon was injured most frequently, followed by SSP + SSC tendon, SSP + ISP tendon, SSP tendon, and SSC tendon.

Figure 4

UCLA score. At the last follow-up, the UCLA score improved from the preoperative mean of 20.4 points to 30.6 points. There was significant difference between preoperative and last follow-up score in the JOA score (P < 0.01).

Figure 5

JOA score. At the last follow-up, the JOA score improved from the preoperative mean of 76.4 points to 90.2 points. There was significant difference between preoperative and last follow-up score in the JOA score (P < 0.01).