Shoulder symptoms in healthy athletes: a comparison of outcome scoring systems.

We used the Rowe, ASES, UCLA, Constant-Murley, and the Simple Shoulder Test scoring systems to determine the presence and severity of shoulder symptoms in "healthy" collegiate athletes at mid-season. Intercollegiate athletes were surveyed with a single, specific, comprehensive questionnaire regarding both of their shoulders at the mid-season of their respective sport. The questionnaire compiled the previously mentioned scoring systems and additional inquiries. Shoulders were divided into three groups for analysis: dominant-never injured, nondominant-never injured, and history of injury. Significant shoulder symptoms exist in athletes during full participation in their respective sport. Pain was the most frequent symptom, with 47% of all shoulder having some degree of pain. The frequency and degree of symptoms was significantly greater in shoulders with a history of injury. The UCLA scoring system is the most sensitive for evaluating "healthy" athletes at mid-season. However, the ideal shoulder scoring system for athletes has yet to be developed. To expect a "normal" or "symptom-free" shoulder after injury or surgery may be inappropriate. This information can serve as a reference for clinicians when evaluating the results of surgery and other treatment programs.

End-to-end operative repair of Achilles tendon rupture.

We present the long-term results of operative repair in 23 consecutive patients with Achilles tendon ruptures, treated between 1984 and 1991, to evaluate our treatment method and determine the clinical causes of rupture. Fifty-four percent of ruptures occurred in people in their 30s; 90% occurred during participation in acceleration-deceleration sports. All but three patients were treated within 1 week of injury with open, operative, end-to-end repair of the Achilles tendon. The remaining three patients were treated more than 3 weeks after injury. All patients followed a standard postoperative regimen. Followup averaged 3.6 years (range, 1 to 7.5). Seventeen patients were available for Cybex analysis, and the remaining patients were interviewed personally or by telephone. Subjectively, patients were very satisfied with the results of treatment. Objectively, physical examination and Cybex testing to measure strength and endurance revealed results somewhat better than those previously reported with operative repair. No patient experienced a rerupture, although one attenuated repair was noted 9 months postoperatively. Only two minor wound problems were recorded. Long-term results revealed near-normal function when comparing the injured side with the uninjured side. Ninety-two percent of patients returned fully to their preinjury levels of activity.