Shoulder range of motion in competitive tennis players: systematic review and meta-analysis.

Background: To compare shoulder range of motion (ROM) in dominant vs. nondominant shoulder of competitive tennis players, and to determine whether shoulder ROM is different between younger and older players, or males and females. Methods: A search was performed on PubMed, Embase, and Epistemonikos on December 18, 2023. This study conforms to the principles of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Clinical studies or case reports on shoulder ROM including external rotation (ER; shoulder at 90° of abduction) and internal rotation (IR) in competitive, elite, or professional tennis players. Results: We found 25 eligible studies that reported on a total of 18,534 tennis players, of which 20 studies reported the ROM for the dominant and nondominant side. Comparing dominant vs. nondominant shoulders revealed that dominant shoulders had significantly smaller IR (53.0° vs. 62.6°; P < .001). Comparing adults vs. children revealed that adults have significantly smaller IR (44.5° vs. 57.1°; P < .001) and ER (95.3° vs. 110.3°; P < .001). Comparing females vs. males revealed no significant differences in ER (113.4° vs. 104.9°; P = .360) or IR (54.3° vs. 56.4°; P = .710). Conclusion: IR in shoulders of tennis players is significantly smaller in dominant vs. nondominant sides (53.0° vs. 62.6°, P < .001), and significantly smaller in adults vs. children (44.5° vs. 57.1°, P < .001). These findings could be relevant in the context of physical preparation and training of tennis players, to monitor evolution of IR as a result of their sport and/or as they transition from childhood to adulthood.

Pyrocarbon humeral heads for hemishoulder arthroplasty grant satisfactory clinical scores with minimal glenoid erosion at 5-9 years of follow-up.

BACKGROUND: Hemishoulder arthroplasty (HSA) is a more conservative alternative to total shoulder arthroplasty for young and active patients with minimal glenoid erosion or deformity. Pyrocarbon humeral heads were introduced as an alternative to metallic humeral heads, which were associated with glenoid erosion in 28%-43%. The purpose of this study was to evaluate the progression of glenoid erosion and clinical scores of HSA using pyrocarbon humeral heads from short- (2-4 years) to midterm (5-9 years). METHODS: We retrieved the records of 45 consecutive patients who underwent HSA with pyrocarbon humeral heads from 2013 to 2017. Patients were evaluated radiographically and clinically at a first follow-up (2-4 years) and a second follow-up (5-9 years). Preoperative glenoid morphology was assessed using computed tomography scans, and glenoid erosion was assessed using plain radiographs according to Sperling et al. The Constant score (CS), American Shoulder and Elbow Surgeons (ASES) score, and Subjective Shoulder Value (SSV) score were assessed by an independent observer. RESULTS: From the initial cohort of 45 patients, 2 underwent revision surgery (4.4%) due to persistent pain (without signs of rotator cuff pathology or glenoid erosion) and 6 were lost to follow-up (13%), leaving 37 for outcome assessment (82%). At the first follow-up of 2.2 ± 0.4 years, all clinical scores improved substantially (CS from 29.3 ± 13.5 to 76.7 ± 14.4, ASES from 23.7 ± 15.6 to 87.0 ± 16.0, and SSV from 25.3 ± 12.2 to 84.1 ± 15.2), and at the second follow-up of 6.2 ± 1.2 years, good clinical scores were maintained (CS from 76.7 ± 14.4 to 80.8 ± 16.0, ASES from 87.0 ± 16.0 to 92.3 ± 15.0, and SSV from 84.1 ± 15.2 to 82.8 ± 18.3). At the second follow-up, glenoid erosion was moderate in 9 (24%) and severe in 3 (8.1%). When comparing with immediate postoperative radiographs, 10 shoulders exhibited progression of glenoid erosion by 1 grade (n = 9) or 2 grades (n = 1). CONCLUSION: Pyrocarbon humeral heads for HSA grant satisfactory clinical scores with minimal glenoid erosion.

Surgical Approach for RSA has Little or no Influence on Scapular Inclination and Glenoid Baseplate Tilt Relative to the Horizontal.

Purpose: Determine whether reverse shoulder arthroplasty (RSA) glenoid baseplate tilt is influenced by surgical approach and/or associated with functional scores. Methods: In total, 501 shoulders (483 patients) who underwent RSA, by anterosuperior (AS, n = 88) or deltopectoral (DP, n = 413) approach. Preoperative and immediate postoperative anteroposterior and scapular Y-view radiographs were used to measure: Inclination of the supraspinatus fossa's floor relative to the horizontal (Sigma angle), inclination of the glenoid fossa line (or glenoid baseplate surface) relative to the horizontal (beta-h angle) or to the supraspinatus fossa's floor (beta-s angle). Results: Sigma and beta-h were significantly greater for shoulders operated by DP approach, both preoperatively (P < .001, P = .002) and postoperatively (P = .004, P < .001), but net change was not significantly different (P = .501, P = .742). Conversely, beta-s was significantly greater for shoulders operated by DP approach, only postoperatively (P = .042), but there were no significant differences in either preoperative angles (P = .580) or net change thereof (P = .528). Conclusion: Beta-s was slightly but significantly greater for shoulders operated by DP approach, while beta-h and sigma depended primarily on preoperative scapular inclination and glenoid tilt, rather than on surgical approach. At a minimum of 2 years following RSA, neither constant scores nor net improvements thereof were significantly associated with any of the angles. Level of evidence: IV, case series.