Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review: Response

Abdul-Rassoul, Hussein; Galvin, Joseph W.; Curry, Emily J.; Simon, Jason E.; Li, Xinning

doi:10.1177/0363546519825642

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…In a previous study by our group, we noted that the reporting of RTS and return to preinjury level suffers from the lack of a clear consensus definition as to what these terms specifically mean to athletes. 1 RTS could refer to patient-athletes returning to organized team activities, full-speed practice, full competition for some period of time, or an entire season of competition. Within our study, we used our own judgment in reporting RTS rates for the study by Ardern et al, 3 which reported on patients who "attempted" to return to sport or patients who returned to sport at final follow-up.…”

Section: Discussionmentioning

confidence: 99%

Return to Sport After ACL Reconstruction With a BTB Versus Hamstring Tendon Autograft: A Systematic Review and Meta-analysis

Defazio

Curry

Gustin

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Anterior cruciate ligament (ACL) tears are debilitating injuries frequently suffered by athletes. ACL reconstruction is indicated to restore knee stability and allow patients to return to prior levels of athletic performance. While existing literature suggests that patient-reported outcomes are similar between bone–patellar tendon–bone (BTB) and hamstring tendon (HT) autografts, there is less information comparing return-to-sport (RTS) rates between the 2 graft types. Purpose: To compare RTS rates among athletes undergoing primary ACL reconstruction using a BTB versus HT autograft. Study Design: Systematic review; Level of evidence, 4. Methods: The MEDLINE, Embase, and Cochrane Library databases were searched, and studies that reported on RTS after primary ACL reconstruction using a BTB or HT autograft were included. Studies that utilized ACL repair techniques, quadriceps tendon autografts, graft augmentation, double-bundle autografts, allografts, or revision ACL reconstruction were excluded. RTS information was extracted and analyzed from all included studies. Results: Included in the review were 20 articles investigating a total of 2348 athletes. The overall RTS rate in our cohort was 73.2%, with 48.9% returning to preinjury levels of performance and a rerupture rate of 2.4%. The overall RTS rate in patients after primary ACL reconstruction with a BTB autograft was 81.0%, with 50.0% of athletes returning to preinjury levels of performance and a rerupture rate of 2.2%. Patients after primary ACL reconstruction with an HT autograft had an overall RTS rate of 70.6%, with 48.5% of athletes returning to preinjury levels of performance and a rerupture rate of 2.5%. Conclusion: ACL reconstruction using BTB autografts demonstrated higher overall RTS rates when compared with HT autografts. However, BTB and HT autografts had similar rates of return to preinjury levels of performance and rerupture rates. Less than half of the athletes were able to return to preinjury sport levels after ACL reconstruction with either an HT or BTB autograft.

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Section: Discussionmentioning

confidence: 99%

Return to Sport After ACL Reconstruction With a BTB Versus Hamstring Tendon Autograft: A Systematic Review and Meta-analysis

Defazio

Curry

Gustin

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…In a systematic review of 31 articles on surgical procedures to treat anterior shoulder instability, Hurley et al [22] reported that at a mean follow-up of 83.5 months (range, 21-240), 73% of patients resumed their sports at the same or higher level. In another systematic review, Abdul-Rassoul et al [1] reported that at a mean follow-up of 61 months Table 4 Uni-and multivariable regression analysis for time (months) to return to sport (range, 12-144), 84% of patients resumed their sports after the Latarjet procedure, the majority of which returned to their preinjury level. Privitera et al [30] reported that at a follow-up of 52 months (range, 24-120), 49% of patients returned to their competitive sport at their preinjury level, and 14% of patients returned to their competitive sport at a decreased level.…”

Section: Discussionmentioning

confidence: 99%

Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

Bohu

Abadie

Rooij

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Systematic reviews report return to play (RTP) within 5.8 months (range, 3–8) following the Latarjet procedure, but the factors that influence RTP remain unknown. The present study aimed to report the rate and time of return to play (RTP) during the first 8 months following the Latarjet procedure, and to determine the influence of sport type or patient characteristics. Methods The authors retrospectively collected the records of patients that underwent Latarjet procedures for anterior shoulder instability between 2015 and 2017. Patients were excluded if they had any concomitant rotator cuff tendon lesions, or previous ipsilateral shoulder surgery. The authors retrieved patient demographics, time from injury to surgery, type of sport practiced (overhead/non-overhead, contact/non-contact), as well as pre- and postoperative Western Ontario Shoulder Instability index (WOSI), Shoulder Instability-Return to Sport After Injury index (SIRSI), and Rowe score. Results A total of 217 patients (217 shoulders) were eligible for inclusion, comprising 184 males and 33 females, aged 26.8 ± 7.3 years at index surgery. The main sport practiced prior to surgery involved overhead (n = 173, 80%) and/or contact (n = 152, 70%) activities. By 8 month follow-up, 158 patients (73%) resumed their main sport, at a mean of 5.1 ± 1.5 months. Multivariable analysis revealed that RTP was more likely in patients with higher preoperative Rowe score (OR, 1.02; p = 0.024) and SIRSI score (OR, 1.02; p = 0.008). Conclusions By 8 months following the Latarjet procedure, 73% of patients had resumed their main sport. The likelihood of RTP was significantly associated with preoperative Rowe and SIRSI scores, but not with sport type. Level of evidence IV.

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“…Historically, the time frame of 90 days postoperatively was recommended to allow more aggressive physical therapy and stress on the shoulder after an OL procedure. 23 In a systematic review, Abdul-Rassoul et al 1 reported that the effective period for athletes to return to sports after a Latarjet procedure was up to 5 months, regardless of the technique used. Therefore, there is a clear transition period of 3 to 6 months, which corresponds to the time periods for CT scan assessment that we recommend.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, resuming sports activity at the preinjury level as soon as possible is an integral part of the successful results after surgical treatment of shoulder instability. 1,13 To our knowledge, there are no clear criteria allowing patients to expose the shoulder to risky situations, and the goal of postoperative care is to place the athletes in the most secure conditions to avoid the recurrence of injury. Historically, the time frame of 90 days postoperatively was recommended to allow more aggressive physical therapy and stress on the shoulder after an OL procedure.…”

Section: Discussionmentioning

confidence: 99%

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Short-Term Bone Fusion With Arthroscopic Double-Button Latarjet Versus Open-Screw Latarjet

Bonnevialle

Girard

Martinel³

et al. 2021

Am J Sports Med

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Background: Recently, arthroscopic double-button Latarjet (AL) has provided an alternative to conventional open Latarjet (OL) in the treatment of anterior shoulder instability with glenoid bone loss. Therefore, theoretically, the faster fusion is obtained, the sooner return to sports under safe conditions can occur. The emerging flexible fixation of the bone block has clearly offered a new approach to achieve bone fusion. However, the period required to achieve this goal remains controversial. Purpose/Hypothesis: The purpose was to compare computed tomography (CT) scan results of AL and OL in the early postoperative period. It was hypothesized that the bone block fusion with AL would require a longer time than that with OL. Study Design: Cohort study; Level of evidence, 3. Methods: In a retrospective 1-year study, the authors compared 17 primary double-button AL to 22 primary 2-screw OL procedures indicated for anterior shoulder instability in patients with an Index Severity Instability Score >3 points. These patients were reviewed with a CT scan at 1 day, 3 months, and 6 months postoperatively. The characteristics for the 2 groups were comparable. CT scans aimed to analyze graft position, bone contact area with the scapula, and fusion at 3 and 6 months. Clinical assessment was based on the Walch-Duplay and Rowe scores. Results: The mean preoperative Index Severity Instability Score was 5.3 ± 1.9 points, with a mean anterior glenoid bone loss of 9.1% ± 4.6%. At 3 months, the rates of fusion were 41% and 100% for the AL and OL groups, respectively ( P < .001). This rate increased to 70% in the AL group at 6 months ( P = .006). In the axial and sagittal planes, there was no difference in graft position between the AL group and the OL group. The bone block was longer and there was a more extensive bone contact area in the OL group (AL, 131 mm2 vs OL, 223 mm2; P < .001). At 6 months of follow-up, no significant difference in clinical scores was noted between the groups: Walch-Duplay score, 93.0 ± 10.9 points versus 91.8 ± 12.5 points ( P = .867); and Rowe score, 99.0 ± 2.2 points versus 95.0 ± 8.4 points ( P = .307) for the AL and OL groups, respectively. Conclusion: AL required more time to achieve bone block fusion than OL. This finding should be taken into account when considering this procedure for patients in a hurry to return to sports involving the shoulder.

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Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review: Response

Cited by 17 publications

References 31 publications

Return to Sport After ACL Reconstruction With a BTB Versus Hamstring Tendon Autograft: A Systematic Review and Meta-analysis

Return to Sport After ACL Reconstruction With a BTB Versus Hamstring Tendon Autograft: A Systematic Review and Meta-analysis

Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

Short-Term Bone Fusion With Arthroscopic Double-Button Latarjet Versus Open-Screw Latarjet

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