Abstract
PurposeTo determine the sensorimotor and clinical function of patients with confirmed successful outcome after either undergoing acromioclavicular joint (ACJ) stabilization, Bankart repair (BR), or rotator cuff repair (RC), and to compare these measures to the contralateral, healthy side without history of previous injuries or surgeries of the upper extremity. It was hypothesized that patients of each interventional group would have inferior sensorimotor function of the shoulder joint compared to the contralateral, healthy side, while presenting with successful clinical and functional outcomes.MethodsThree intervention groups including ten patients who had confirmed successful clinical and functional outcomes after either undergoing ACJ stabilization, BR, or RC were evaluated postoperatively at an average follow-up of 31.7 ± 11.6 months. Additionally, a healthy control group (CG) of ten patients was included. Clinical outcomes were assessed using the Constant–Murley (CM) and American Shoulder and Elbow Surgeons (ASES) Score. Pain was evaluated using the visual analogue scale (VAS). Sensorimotor function was assessed by determining the center of pressure (COP) of the shoulder joint in a one-handed support task in supine position on a validated pressure plate.ResultsEach interventional group demonstrated excellent clinical outcome scores including the CM Score (ACJ 83.3 ± 11.8; BR 89.0 ± 10.3; RC 81.4 ± 8.8), ASES Score (ACJ 95.5 ± 7.0; BR 92.5 ± 9.6; RC 96.5 ± 5.2), and VAS (ACJ 0.5 ± 0.9; BR 0.5 ± 0.8; RC 0.5 ± 0.8). Overall, the CG showed no significant side-to-side difference in COP, whereas the ACJ-group and the BR-group demonstrated significantly increased COP compared to the healthy side (ACJ 103 cm vs. 98 cm, p = 0.049; BR: 116 cm vs. 102 cm, p = 0.006). The RC-group revealed no significant side-to-side difference (120 cm vs. 108 cm, n.s.).ConclusionCentre of pressure measurement detected sensorimotor functional deficits following surgical treatment of the shoulder joint in patients with confirmed successful clinical and functional outcomes. This may indicate that specific postoperative training and rehabilitation protocols should be established for patients who underwent surgery of the upper extremity. These results underline that sensorimotor training should be an important component of postoperative rehabilitation and physiotherapeutic activities to improve postoperative function and joint control.Level of evidenceIV.
Highlights
Postoperative limited sensorimotor function compromises sufficient joint stability along with an increased risk of future re-injuries [1,2,3]
Detailed knowledge regarding sensorimotor shoulder function following surgery and their impact on clinical outcomes remains limited. This is of clinical relevance, as improved sensorimotor function may lead to better clinical outcomes, higher patient satisfaction, and reduced risk of re-injury in the long term
Beitzel et al recently demonstrated that elite youth javelin throwers demonstrated structural changes, even though they did not present with a history of pain or injury of the shoulder, underlining the importance of continuous postoperative rehabilitation [18]
Summary
Postoperative limited sensorimotor function compromises sufficient joint stability along with an increased risk of future re-injuries [1,2,3]. The sensorimotor system has been reported to play an integrative role by mediating static and dynamic stabilizers, ensuring optimal function and stability of the shoulder joint [1, 4,5,6,7]. Edouard et al implemented a novel testing protocol to assess the sensorimotor function of the shoulder [2]. Detailed knowledge regarding sensorimotor shoulder function following surgery and their impact on clinical outcomes remains limited. This is of clinical relevance, as improved sensorimotor function may lead to better clinical outcomes, higher patient satisfaction, and reduced risk of re-injury in the long term
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