Pavlik A, Tátrai M, Papp E. Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability.
Orthop J Sports Med 2020;
8:2325967120969151. [PMID:
33415175 PMCID:
PMC7750762 DOI:
10.1177/2325967120969151]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background:
Arthroscopic treatment of posterior shoulder instability has become more
popular and effective in recent years, but few data are available concerning
the rate of return to sport.
Purpose:
To present our experiences with arthroscopic posterior labral reconstruction
in athletes and review our results, with a particular focus on the rate of
return to sport.
Study Design:
Case series; Level of evidence, 4.
Methods:
Included in the study were 40 arthroscopic stabilizations performed because
of posterior shoulder instability in 37 athletes at a single institution.
During follow-up, the athletes’ rate of return to sport was calculated.
Shoulder function was evaluated based on a pre- versus postoperative
comparison of the Rowe instability score and the American Shoulder and Elbow
Surgeons score. Additionally, the return-to-sport rate was compared among
different subgroups: traumatic versus atraumatic origin of injury,
competitive versus recreational athletes, high-risk versus low-risk sport,
and posterior-only versus anterior and posterior stabilization. Data were
statistically analyzed using paired-samples t test and
nonparametric Fisher exact test.
Results:
The average follow-up period was 54.4 months (range, 24-112 months). Three
shoulders (7.5%) continued to have posterior subluxations postoperatively.
There were 34 excellent, 3 good, and 3 fair results based on the Rowe score
(average postoperative score, 92.9), and patients achieved an average
postoperative American Shoulder and Elbow Surgeons score of 92.7. The pre-
to postoperative improvement was statistically significant in both scoring
systems (P < .001). Of the 37 patients, 36 (98.2%) were
able to return to sport activity: 27 of them (72.9%) to their original sport
and 19 (51.4%) at their preinjury level. A significantly higher rate of
return to the same sport occurred in athletes who had traumatic injury
compared with a subgroup of athletes without a traumatic event
(P < .02).
Conclusion:
More than half of the athletes were able to return to their preinjury level
of sport after arthroscopic posterior labral reconstruction. In addition,
low recurrence rates and good functional outcomes were seen in >90% of
the patients, and 98% returned to sport activity. The athletes had a
significantly higher rate of return to sport if their posterior shoulder
instability had a clear traumatic origin.
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