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. 2024 Oct 10;7(3):101028.
doi: 10.1016/j.asmr.2024.101028. eCollection 2025 Jun.

Division 1 Collegiate American Football Players Experience a Low Revision Rate After Undergoing Arthroscopic Shoulder Labral Repair

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Division 1 Collegiate American Football Players Experience a Low Revision Rate After Undergoing Arthroscopic Shoulder Labral Repair

Camila Grandberg et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To describe rates of revision surgery and recurrence events, as well as to evaluate functional outcomes and return to play (RTP) of a cohort of Division 1 (D1) collegiate American football players who underwent arthroscopic labral repair for shoulder instability.

Methods: D1 collegiate American football players undergoing arthroscopic surgical management of shoulder instability between 2017 and 2021 at a single institution were included. Demographics, imaging, surgical details, and postoperative outcomes, including revision surgery and Western Ontario Shoulder Instability Index (WOSI), were collected. Hill-Sachs lesions and glenoid bone loss were evaluated on magnetic resonance imaging.

Results: Fifteen shoulders of 15 consecutive male athletes were included, with mean age of 19.7 ± 1.0 years and mean follow-up of 2.1 ± 1.0 years. Twelve injuries were shoulder subluxations and 3 were dislocations. Seven cases were posterior injuries, 4 were anterior, and 4 included both anterior and posterior injuries. All patients underwent arthroscopic labrum repair alone, without remplissage or any additional open procedures. A mean of 6 anchors were used in each shoulder, with anchors being placed in at least 2 quadrants. Hill-Sachs lesions were observed in 6 shoulders (40%). Thirteen shoulders had no glenoid bone loss, and 2 had >15% glenoid bone loss. Two shoulders required revision surgery. Significant differences were found in postoperative WOSI scores between patients with and without recurrent instability (66.9 ± 11.5% vs 94.6 ± 5.0%), and between patients with and without Hill-Sachs lesions (84.6 ± 14.7% vs 95.0 ± 5.9%). Fourteen patients (93%) RTP at the same level.

Conclusions: Arthroscopic labral repairs as a treatment for shoulder instability in D1 American football players, without remplissage/bone block procedures, yielded low recurrence and revision rates, and a high RTP rate. Additionally, Hill-Sachs lesions and recurrent shoulder instability were associated with inferior postoperative subjective outcomes (WOSI score).

Level of evidence: Level IV, therapeutic case series.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: I.D.E. funding grants from Arthrex, Smith & Nephew, and Mid-Atlantic Surgical Systems. J.D.H. reports funding grants from Mid-Atlantic Surgical Systems, Smith & Nephew, Arthrex, and Plant Medical; and travel reimbursement from SI-BONE. V.M. reports consulting or advisory, funding grants, and speaking and lecture fees from Smith & Nephew; funding grants from Arthrex and DePuy Synthes; board membership with the International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine; and deputy editor-in-chief of Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA). All other authors (C.G., N.A.B., J.K., A.J.P., M.S.R., B.M.G.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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