Patient outcomes and return to play after arthroscopic rotator cuff repair in overhead athletes: a systematic review

Abstract

Background Rotator cuff tear injuries in overhead athletes are common and may lead to chronic pain and joint disability, impairing sport participation and leading to premature retirement. The improvement of the patient reported outcome measures (PROMs) was evaluated, as were the time and level of return to sport and the rate of complication in overhead athletes who had undergone arthroscopic rotator cuff repair. Methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In September 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar and Embase. No time constraints were used for the search. All the clinical trials investigating arthroscopic rotator cuff repair in overhead athletes were accessed. Results Data from 20 studies were collected. The mean length of the follow-up was 40 months. All PROMs improved at last follow-up: Kerlan-Jobe Orthopaedic Clinic score (P = 0.02), visual analogue scale (P = 0.003), Constant score (P < 0.0001), University of California Los Angeles Shoulder score (P = 0.006) and American Shoulder and Elbow Surgeons’ score (P < 0.0001). Elevation also improved (P = 0.004). No difference was found in external and internal rotation (P = 0.2 and P = 0.3, respectively). In total, 75.4% (522 of 692 of patients) were able to return to play within a mean of 6.4 ± 6.0 months. Of 692 patients, 433 (62.5%) were able to return to sport at pre-injury level. Fourteen out of 138 patients (10.1%) underwent a further reoperation. The overall rate of complications was 7.1% (20 of 280). Conclusion Arthroscopic reconstruction of the rotator cuff is effective in improving function of the shoulder in overhead athletes, with a rate of return to sport in 75.4% of patients within an average of 6.4 months. Level of evidence III, systematic review. Trial registration : Not applicable.

Criteria, Timing, and Factors Associated With Return to Competitive Sport After Rotator Cuff Surgery

“…Most of the athletes return to physical activity after at least 6 months from surgery. 18,26,51,56 Reuter et al 51 and Kholinne et al 26 reported longer time to RTS, 8.3 and 10.3 months, respectively. This discrepancy could be correlated with the heterogeneity of studied populations and sports.…”

“…Most of the athletes return to physical activity after at least 6 months from surgery 18,26,51,56 . Reuter et al 51 and Kholinne et al 26 reported longer time to RTS, 8.3 and 10.3 months, respectively.…”

“…Despite a high rate of return to play, only a few achieve the preoperative level 16 . In a recent review, Migliorini et al 18 reported that double-row repair is the most used technique. The single row was recommended for tears < 1 cm, while indications for tears between 1 and 3 cm are unclear.…”

Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta‐analysis

“…Meniscal tears have different aetiologies and injury patterns [44, 47, 60]. First, a distinction is made between acute and degenerative tears [39, 56]. Acute tears are commonly the result of trauma or sports injuries.…”

Rehabilitation and Return to Play of an Ice-Hockey Athlete after Lateral Meniscus Repair: A Case Report

“…Scholars have also yet to more thoroughly consider matters related to injury recurrence after surgery in this context. For example, long-term observation studies have demonstrated that 19% of meniscus repairs fail [29], and the surgical method applied for such repairs, the all-inside technique, has shown a higher probability of returning to the game after recovery to the level before injury than the inside-out technique; at the same time, the injury recurrence rate is higher [30]. In addition, osteoarthritis can occur secondary to meniscus damage [31], making evaluation through remeasurement of functional aspects a necessity in follow-up studies to identify the negative effects of injuries and surgeries.…”