Purpose This study aims to determine the rate of diferent levels of return to sports (RTS) in athletes undergoing the modiied arthroscopic Bristow procedure and the factors associated with the level of RTS.
MethodsThe study was performed retrospectively on patients with traumatic anterior shoulder instability who underwent the modiied arthroscopic Bristow procedure with a minimum follow-up of 2 years. The RTS rate, the level of return and the timing of return were assessed. Additionally, factors such as preoperative basic information, clinical outcomes, graft position, graft healing and graft absorption were analysed to investigate their correlation with the level of RTS. Multivariate regression models were used to evaluate the factors afecting the level of RTS. Results In total, this study included 182 shoulders of 177 athletes undergoing the modiied arthroscopic Bristow procedure. Of these patients, 142 (78.0%) shoulders of 137 athletes were enrolled, with a mean of 3.3-year follow-up. At the inal follow-up, 134 (94.4%) shoulders were able to RTS, 123 (86.6%) shoulders were able to RTS to the pre-injury level, 52 (36.6%) shoulders could be completely "forgotten" without any psychological barrier during exercise. The multivariate logistic regression analysis identiied the variable associated with RTS at the pre-injury level as previously failed arthroscopic Bankart repair (p < 0.001). As for the "forgetting" operated shoulder, the duration from irst dislocation to surgery was a signiicant independent predictor (p = 0.034). Conclusion Although a large majority of athletes were able to RTS at the pre-injury level after the modiied arthroscopic Bristow procedure, about two-thirds of the athletes felt diference in shoulders on both sides and could not completely "forget" the operated shoulder during exercise. Previously failed Bankart repair and the duration from irst dislocation to surgery were the risk factors associated with the level of RTS after the modiied arthroscopic Bristow procedure. Level of evidence IV.