Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review.

Journal Article (Review;Journal Article)

Background

Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients.

Purpose

To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures.

Study design

Systematic review; Level of evidence, 4.

Methods

All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score.

Results

Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72).

Conclusion

Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization.

Full Text

Duke Authors

Cited Authors

  • Lau, BC; Pineda, LB; Johnston, TR; Gregory, BP; Wu, M; Fletcher, AN; Ledbetter, L; Riboh, JC

Published Date

  • March 4, 2021

Published In

Volume / Issue

  • 9 / 3

Start / End Page

  • 2325967120982059 -

PubMed ID

  • 33748304

Pubmed Central ID

  • PMC7940729

Electronic International Standard Serial Number (EISSN)

  • 2325-9671

International Standard Serial Number (ISSN)

  • 2325-9671

Digital Object Identifier (DOI)

  • 10.1177/2325967120982059

Language

  • eng