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. 2022 Nov 4;10(11):23259671221133134.
doi: 10.1177/23259671221133134. eCollection 2022 Nov.

Player Position and Labral Tear Location and Size in NCAA Division I Football Players Undergoing Arthroscopic Surgery

Nyaluma N Wagala  1 , Philipp W Winkler  1   2 , Brian M Godshaw  1 , Adam Popchak  1 , Jonathan D Hughes  1 , Albert Lin  1 , Volker Musahl  1
Affiliations

Player Position and Labral Tear Location and Size in NCAA Division I Football Players Undergoing Arthroscopic Surgery

Nyaluma N Wagala et al. Orthop J Sports Med. .

Abstract

Background: Shoulder instability attributed to glenoid labral tears is common among National Collegiate Athletic Association (NCAA) football players. Certain repetitive activities by player position may contribute to instability.

Purpose: To compare the location of labral tears among player positions in NCAA Division I football.

Study design: Cross-sectional study.

Methods: We conducted a review of football players who underwent shoulder labral repair between 2000 and 2020 at a single institution. Inclusion criteria were NCAA Division I level, diagnosis of shoulder instability, and labral tear requiring arthroscopic repair. Exclusion criteria were prior surgery on injured shoulder and incomplete medical records. Players were divided into 3 groups: line players (offensive and defensive linemen, defensive end), skill players (defensive back, wide receiver, running back, and quarterback), and hybrid players (linebacker and tight end). Labral tear location and size were recorded using the clockface method and categorized into 6 zones: superior, anterosuperior, anteroinferior, inferior, posteroinferior, and posterosuperior. Comparison of variables was performed using chi-square test or Fisher exact test (categorical) and 1-way analysis of variance or Kruskal-Wallis H test (continuous). The Spearman rank-order correlation was used to assess relationships between continuous data.

Results: Of the 53 included players, 37 (70%) were offensive linemen, defensive linemen, and linebackers. There were 29 line players, 11 skill players, and 13 hybrid players. Line players represented 55% of included players and had the most total labral tears as compared with all groups. Hybrid players had a significantly higher percentage of posterosuperior tears than line players (92% vs 52%; P = .015) and skill players (92% vs 27%; P = .002). Skill players had a significantly higher percentage of anterior tears at 3:00-4:00 and 5:00-6:00 when compared with hybrid players (82% vs 15%, P = .003; 82% vs 31%, P = .012, respectively). There was a positive correlation between labral tear size and number of suture anchors (0; P = .010).

Conclusion: In this study of NCAA Division I football players, skill players had a higher proportion of anteroinferior labral tears, and hybrid players had a higher proportion of posterosuperior labral tears.

Keywords: football; labral tear; shoulder dislocation; shoulder instability.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J.D.H. has received grant support from Arthrex, education payments from Pylant Medical and Smith & Nephew, and hospitality payments from SI-BONE. A.L. has received education payments from Mid-Atlantic Surgical Systems, consulting fees from Tornier/Stryker and Arthrex, nonconsulting fees from Arthrex, and honoraria from Wright Medical. V.M. has received educational grants, consulting fees, and speaking fees from Smith & Nephew and educational grants from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Methods of dividing glenoid for labral tears. (A) Clockface method. For right and left shoulders, 3:00 faces anteriorly and 9:00 faces posteriorly. The angle between each hour represents 30° of the labrum. (B) Six zones. Each zone represents 60° of the labrum.
Figure 2.
Figure 2.
Proportion of labral tears by location for position groups. Percentage of labral tears within each zone correspond to the legend. Dark green represents 0% and red 100%.
See this image and copyright information in PMC

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