A Qualitative Investigation of Return to Sport After Arthroscopic Bankart Repair

Tjong, Vehniah K.; Devitt, Brian M.; Murnaghan, M. Lucas; Ogilvie-Harris, Darrell; Theodoropoulos, John

doi:10.1177/0363546515590222

Cited by 76 publications

(107 citation statements)

References 29 publications

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“…While the majority have focused on quantitative outcomes, there are several studies that emphasize the importance of psychological factors in a patient’s decision to return to sport. 39,49–51 The patient-derived themes from this study of patients with FAI also support this phenomenon.…”

Section: Discussionsupporting

confidence: 61%

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A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Tjong

Cogan

Riederman

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears.Purpose:To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI.Study Design:Case series; Level of evidence, 4.Methods:An experienced interviewer conducted qualitative, semistructured interviews of patients aged 18 to 60 years who had arthroscopic hip surgery for FAI. All had preinjury participation in sport and a minimum 2-year follow-up with no revision surgery. Qualitative analysis was then performed to derive codes, categories, and themes. An assessment of preinjury and current sports participation by type, level of competition, and frequency along with patient-reported hip function was also obtained. In addition, current modified Harris Hip Score (mHHS), international Hip Outcome Tool (iHOT-12), Hip Outcome Score–sports-specific subscale (HOS-SSS), and a coping mechanism evaluation (Brief COPE) were also recorded.Results:A total of 23 patients were interviewed to reveal the overarching themes of internal motivation, external encouragement, and resetting expectations as the predominant factors influencing a patient’s decision to return to preinjury sport. Subjective outcome measurements (mHHS, iHOT-12, patient satisfaction) showed significant differences between patients who did and did not return to sport. Interestingly, the adaptive and maladaptive coping mechanisms matched and supported our themes in those patients who described fear and self-motivation as defining features influencing their cessation of or return to play, respectively.Conclusion:Self-motivation, aging, pain, encouragement from others, and adapting to physical limitations can largely affect a patient’s decision to return to sport after arthroscopic hip surgery for FAI. Innate coping mechanisms may also help to predict the course of and subsequently aid in a patient’s postoperative recovery.

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Section: Discussionsupporting

confidence: 61%

“…Recent literature has highlighted the use of qualitative methods to delineate themes and patient-derived outcomes pertaining to this phenomenon. 39,49 The goal of this study was to understand the factors that contribute to a patient’s decision to return to play after arthroscopic hip surgery for FAI.…”

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confidence: 99%

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Tjong

Cogan

Riederman

et al. 2016

Orthopaedic Journal of Sports Medicine

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“…31,42 This may lead to recurrent ASDs and symptoms for longer periods, 3 reduced participation in physical activity, and decreased shoulder-related quality of life. 16,37,44 Diverging strategies exist as to the optimum treatment for this group. For young, active male patients with primary traumatic ASDs, 2 systematic reviews have concluded that shoulder stabilizing surgery with postsurgical shoulder rehabilitation was superior to nonsurgical standard care treatment only in reducing the risk of recurrent ASDs.…”

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confidence: 99%

Neuromuscular Exercises Improve Shoulder Function More Than Standard Care Exercises in Patients With a Traumatic Anterior Shoulder Dislocation: A Randomized Controlled Trial

Eshøj

Rasmussen

Frich

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: There is an important gap in knowledge about the effectiveness of nonoperative treatment (exercise) for patients with traumatic primary and recurrent anterior shoulder dislocations (ASDs).Purpose/Hypothesis: The purpose of this study was to assess the efficacy and safety of physical therapist-supervised, shoulder instability neuromuscular exercise (SINEX) versus self-managed, home-based, standard care shoulder exercise (HOMEX) in patients with traumatic ASDs. The hypothesis was that SINEX would have a larger effect and fewer adverse events compared with HOMEX.Study Design: Randomized controlled trial; Level of evidence, 2.Methods: A total of 56 participants with radiographically verified, trauma-initiated primary or recurrent ASDs and self-reported decreased shoulder function were randomized to 12 weeks of either SINEX or HOMEX. The SINEX program consisted of 7 exercises, individually progressing from basic (2 Â 20 repetitions each day) to elite (2 Â 10 repetitions, 3 times weekly). The HOMEX program included 5 shoulder exercises performed 3 times weekly (2 Â 10 repetitions). The primary outcome was the Western Ontario Shoulder Instability Index (WOSI) score, ranging from 0 (best possible) to 2100. The between-group minimal clinically important difference at 12 weeks was 250 points. Secondary outcomes included WOSI subdomain scores, patient-reported ratings of kinesiophobia and pain, objective shoulder function, patient satisfaction, and number of adverse events.Results: The between-group mean difference in the WOSI total score at 12 weeks significantly favored SINEX over HOMEX ). SINEX was furthermore superior to HOMEX in most of the secondary outcomes (3/4 subdomains of the WOSI and pain level during the past 7 days as well as clinical signs of anterior shoulder instability). Also, although not statistically significant, less than half the proportion of the SINEX patients compared with the HOMEX patients (3/27 [11%] vs 6/24 [25%], respectively; P ¼ .204) underwent or were referred for shoulder stabilizing surgery. Satisfaction with both exercise programs was high, and no serious adverse events were reported.Conclusion: Neuromuscular shoulder exercise (SINEX) was superior to standard care exercise (HOMEX) in patients with traumatic ASDs. Further long-term follow-ups on treatment effects are needed.Registration: NCT02371928 (ClinicalTrials.gov identifier).A traumatic anterior shoulder dislocation (ASD) is a common athletic injury among young, active patients. 34 The annual incidence of primary traumatic ASDs is between 11.2 and 26.2 per 100,000 people. 30,32,52 Patients with primary traumatic ASDs are prone to recurrent ASDs because

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“…Many athletes say fear of reinjury hinders their return to the preinjury level 10 11. However, the current focus of rehabilitation is on restoration of physical function, and often physical and psychological readiness states do not coincide.…”

Section: Answers?mentioning

confidence: 99%

It is time for consensus on return to play after injury: five key questions

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A Qualitative Investigation of Return to Sport After Arthroscopic Bankart Repair

Cited by 76 publications

References 29 publications

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Neuromuscular Exercises Improve Shoulder Function More Than Standard Care Exercises in Patients With a Traumatic Anterior Shoulder Dislocation: A Randomized Controlled Trial

It is time for consensus on return to play after injury: five key questions

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