Return to Play After Shoulder Instability Surgery in National Collegiate Athletic Association Division I Intercollegiate Football Athletes

Robins, R. Judd; Daruwalla, Jimmy H.; Gamradt, Seth C.; McCarty, Eric C.; Dragoo, Jason L.; Hancock, Robert E. W.; Guy, Jeffrey A.; Cotsonis, George; Xerogeanes, John W.; Tuman, Jeffrey M.; Tibone, James E.; Javernick, Matthew A; Yochem, Eric M; Boden, Stephanie; Pilato, Alexis; Miley, Jennifer H; Greis, Patrick E.

doi:10.1177/0363546517705635

Cited by 30 publications

(17 citation statements)

References 24 publications

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“…This finding is consistent with previous studies that showed that most glenohumeral subluxations and dislocations were anterior in nature. 8,10,11 In addition, approximately 81% of injuries were caused by contact with another player. This rate is higher than the rates of injuries caused by player contact of 65% to 68% previously reported in all collegiate athletes.…”

Section: Discussionmentioning

confidence: 99%

“…Of the injuries with unknown TL, 57 (53.8%) resulted in the player missing the rest of the season; however, it was impossible to determine how much time remained in the season at the time of injury. Among shoulder instability injuries with known TL, players missed a mean of 8…”

Section: Tl and Surgical Treatmentmentioning

confidence: 99%

“…They also showed that male athletes sustained 2.67 times more instability injuries than female athletes. 1 In a later study, Robins et al 8 determined that football players often returned to play at the same level or a higher level after arthroscopic surgery for shoulder instability; however, these athletes still missed a significant amount of playing time because of their injuries.…”

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confidence: 99%

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Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

Trojan

Meyer

Edgar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Tl and Surgical Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

Trojan

Meyer

Edgar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Although the type of sport could conceivably influence return rates, multiple studies 13,27,29,37,40 have reported rates of 66%-100% for return to the same preinjury level of competition after arthroscopic Bankart anterior shoulder procedures. In a multicenter case series by Robins et al 37 of National Collegiate Athletic Association (NCAA) Division I American football players, an 82% return rate to the same level of play was found after arthroscopic Bankart repair. Similarly, Mazzocca et al 27 reported on a cohort of contact athletes, with 100% of the participants able to return to the same level of play at an average of 5.7 months after undergoing an arthroscopic Bankart repair.…”

Section: Discussionmentioning

confidence: 99%

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

Dekker

Goldenberg

Lacheta

et al. 2020

Orthopaedic Journal of Sports Medicine

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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.

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“…To date, most of the studies regarding outcomes of nonoperative versus surgical management of shoulder instability in professional athletes have been performed on collision athletes, and their findings have mirrored those in the present study regarding a noncollision sport, suggesting superior outcomes in those managed surgically. 9,19,21 Competitive athletes in other sports have also had successful outcomes and return to play after surgical intervention. Mazzocca et al 15 found a 100% rate of return to play in collision and contact athletes after arthroscopic stabilization.…”

Section: Discussionmentioning

confidence: 99%

Performance After Operative Versus Nonoperative Management of Shoulder Instability in the National Basketball Association

Lemme

DeFroda

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Although nonoperative management after shoulder instability injury allows an athlete to return to play sooner than operative intervention, higher rates of recurrence have been observed after nonoperative management. However, no study has investigated the differences in performance of National Basketball Association (NBA) players after index shoulder instability events managed nonoperatively versus operatively.Purpose/Hypothesis:The purpose of this study was to identify shoulder instability events in NBA athletes and assess differences in performance after injury with nonoperative versus operative management. We hypothesized that players who undergo operative intervention have reduced risk of recurrence and are able to continue their elite level of play as opposed to those who undergo nonoperative management.Study Design:Cohort study; Level of evidence, 3.Methods:Publicly available injury data from the 1986-1987 through 2017-2018 seasons were reviewed to identify NBA athletes sustaining a shoulder instability event. In addition to characteristics, player performance information, including games played, player efficiency rating (PER), and win shares, was analyzed before and for 3 seasons after injury. Statistical learning models were applied to identify performance variables that have the greatest predictive value to determine players who would benefit from surgery.Results:A total of 60 players with shoulder instability events were identified between 1986 and 2018. After injury, 37 players (61.7%) eventually underwent surgery and 23 players (38.3%) did not. Players who were treated nonoperatively had significantly decreased PER, games played, and offensive win shares in the season after injury (P < .05). Players who underwent surgery did not see a decline in PER, games played, or win shares. Random forest modeling found that true shooting percentage and win shares per 48 minutes were the performance variables most predictive in determining which players would benefit from surgery after shoulder instability.Conclusion:Players who underwent surgical intervention for shoulder instability maintained their PER, games played, and win share performance characteristics, whereas players who did not undergo surgery had declines in these parameters. Given the demands of shoulder function in basketball and the risk of recurrence after an instability event, surgery enhances a player’s opportunity to maintain a high level of performance after injury.

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Return to Play After Shoulder Instability Surgery in National Collegiate Athletic Association Division I Intercollegiate Football Athletes

Cited by 30 publications

References 24 publications

Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

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

Performance After Operative Versus Nonoperative Management of Shoulder Instability in the National Basketball Association

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