Anterior Shoulder Instability in the Professional Athlete: Return to Competition, Time to Return, and Career Length

Abstract

Background: Anterior shoulder instability is a common condition in professional athletes, yet little is known about the success of surgery. Return to competition (RTC) is a metric indicative of a successful outcome for professional athletes who undergo anterior shoulder stabilization surgery. Purpose: To determine the rate of RTC, time to RTC, recurrence rate, and length of career after surgery in professional athletes who had undergone surgical treatment for anterior shoulder instability. Study Design: Case series; Level of evidence, 4. Methods: We evaluated professional athletes who underwent surgical treatment for anterior shoulder instability by a single surgeon between 2007 and 2018. Data from patients’ medical records, a patient data registry, basic search engines, sports websites, and individual team websites were used to determine length of professional play before injury, duration of career after surgery, and RTC level. Results: Overall, 23 professional athletes (25 shoulders from 12 contact and 13 noncontact athletes) were identified. The mean age at the time of surgery was 24.3 ± 4.9 years (range, 16-35 years). Primary procedures included arthroscopic Bankart repair (76%; 19/25), open Latarjet (20%; 5/25), and bony Bankart repair (4%; 1/25). Of the 23 athletes, 22 returned to their previous level of competition (96%; 95% CI, 78%-100%). The mean time between surgery and RTC was 4.5 months (range, 3-8 months). There was no difference in time to RTC between contact and noncontact athletes (4.1 vs 4.4 months). There was no difference in RTC rates and time to return for players who received a Bankart repair versus a Latarjet procedure (4.6 vs 4.2 months). A total of 12 participants were still actively engaged in their respective sport at an average of 4.3 years since surgery, while 11 athletes went on to retire at an average of 4.8 years. Duration of play after surgery was 3.8 years for contact athletes and 5.8 years for noncontact athletes ( P > .05). Conclusion: In this series, professional athletes who underwent surgical shoulder stabilization for the treatment of anterior glenohumeral instability returned to their presurgical levels of competition at a high rate. No differences in RTC rate or time to RTC were observed for contact versus noncontact athletes or for those who received arthroscopic Bankart repair versus open Latarjet. However, contact athletes had shorter careers after surgery than did noncontact athletes.

Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results

“…20 With high satisfaction rates, Blonna obtained 82% and 84% respectively. 24 Our study showed that both the IP and the HB groups showed a WOSI score of 89.98% and 87.55% respectively, without significant differences ( p 0.012).…”

“…Although these results are below those published in the literature by Dekker, with return to same sports level of 96%, and Mazzocca, 100%, the interviews with the patients showed us that 9 of the 10 patients who did not return to their sports activity corresponds to the sports restrictions imposed by the COVID-19 pandemic, where for long periods of time the sport was limited and even prohibited . 24,27 Hovelius reported in his study excellent results, a WOSI score with an average of 88% with the Latarjet technique and 79% with the Bankart arthroscopic technique. 20 With high satisfaction rates, Blonna obtained 82% and 84% respectively.…”

“…Although these results are below those published in the literature by Dekker, with return to same sports level of 96%, and Mazzocca, 100%, the interviews with the patients showed us that 9 of the 10 patients who did not return to their sports activity corresponds to the sports restrictions imposed by the COVID-19 pandemic, where for long periods of time the sport was limited and even prohibited . 24,27…”

“…13,[21][22][23] As Dekker demonstrated, in his paper where 23 athletes were evaluated, the average sports return was 4.5 months with both techniques. 24 In a comparative study, Blonna recorded an average of 6 months for sports discharge, without differences according to the technique of choice. 25 On the other hand, in his systematic review, Lalenti registered a return to sports at 6.1 (Bankart) versus 5.3 (Latarjet).…”

Open Latarjet Versus Arthroscopic Bankart Repair for the Treatment of Traumatic Anterior Shoulder Instability in High-Demand Patients With Minimal Glenoid Bone Loss

“…Dekker et al [ 23 ] showed no statistically significant difference in return to the competitive rates as well as the return time for athletes who had Bankart repair in comparison to the Latarjet procedure (4.6 vs 4.2 months). Ialenti et al [ 22 ] showed in their systematic review that patients who underwent Bankart repair on average took approximately one month longer to return to sports compared with those who underwent the Latarjet procedure (6.1 vs 5.3 months).…”