Prevalence Of Multidirectional Shoulder Instability In Shot Put Throwers

Objective: The objective of this study was to find out whether there was any shoulder instability prevailing in the shot put throwers due to the rotational activities achieved in the respective sport. Methods: A total of 76 shot put throwers were recruited for the study. The multidirectional instability of the shoulder joint was tested by performing special tests. Results: The study revealed that out of 76 shot put throwers, 49 individuals were found to be having shoulder instability, and 27 individuals were not having shoulder instability. This was confirmed by using a special test like the Sulcus sign and Rowe test followed by statistical analysis. The individuals diagnosed with multidirectional instability showed Sulcus sign and Rowe test positive, of which 30 individuals showed both the test positive and 19 individuals showed only Rowe test positive. Conclusion: About 64.47% of individuals were diagnosed with multidirectional instability in the shot put throwers while the rest 35.52% of individuals showed no signs of instability.

Evaluation of Inferior Capsular Laxity in Patients with Atraumatic Multidirectional Shoulder Instability with Magnetic Resonance Arthrography

OBJECTIVE: To compare inferior capsular redundancy by using magnetic resonance arthrography (MRA) images in patients with multidirectional instability (MDI) of the shoulder and control subjects without instability and thereby develop a screening method to identify the presence of shoulder MDI. MATERIALS AND METHODS: The MRA images of patients with MDI of the shoulder (n = 65, 57 men, 8 women; mean age, 24.5 years; age range, 18–42 years) treated over an eight-year period were retrospectively reviewed; a control group (n = 65, 57 men, 8 women; mean age, 27.4 years; age range, 18–45 years) without instability was also selected. The inferior capsular redundancy was measured using a new method we named the glenocapsular (GC) ratio method. MRA images of both groups were randomly mixed together, and two orthopedic surgeon reviewers measured the cross-sectional areas (CSAs) and sagittal capsule-head ratios on oblique sagittal images, as well as the axial capsule-head ratios on axial images and GC ratios on oblique coronal images. RESULTS: The CSAs and GC ratios were significantly higher in patients than in controls (both, p 1.42 was found to be most suggestive of MDI of the shoulder, owing to its high sensitivity (92.3%) and specificity (89.2%). CONCLUSION: GC ratio can be easily measured and used to accurately screen for MDI of the shoulder.

Medial Anterior-inferior Capsular Shift in Multidirectional Shoulder Instability

Purpose: The purpose of this study was to prove the effectiveness of the open medial (glenoid-based) anteriorinferior capsular shift in patients with multidirectional shoulder instability. Materials and Methods: We reviewed 19 patients treated by medial anterior-inferior capsular shift for multidirectional shoulder instability from March, 1998 to December, 2003. 15 patients of them have experienced recurrent dislocation. 8 patients(42%) showed bilateral laxity and 11 patients(58%) generalized ligamentous laxity, and 2 patients(10.5%) voluntary subluxation. An average follow-up was 24 months (range : 9~32 months). Results: Pain improved in 18 patients of all. There was an average loss of 10 degree of external rotation, but no limitation of activity of daily living. There was no redislocation and subluxation, but two patients had some apprehension in sports activity. With Rowe score, the result was excellent or good in all patients. There were hematoma and local skin problem in 1 patient, but all had healed up. Conclusion: Medial anterior-inferior capsular shift in multidirectional shoulder instability provided satisfactory results in pain relief, patient's satisfactions and stability of glenohumeral joint. Though some of them have anterior gleniod deformities and large Hill-Sachs lesions, we could get good stabilities.