Return to Professional Australian Rules Football After Surgery for Traumatic Anterior Shoulder Instability

Abstract

Background: The treatment of traumatic anterior shoulder instability in professional Australian Football League (AFL) players is challenging, with an emphasis on early return to play and avoidance of instability recurrence. Purpose: To investigate return-to-sport (RTS) outcomes and complications after 2 different procedures for traumatic anterior shoulder instability in professional AFL players. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed our surgical database for professional AFL players who underwent capsulolabral stabilization or open Latarjet procedure by a single surgeon between 2006 and 2017. Outcomes included RTS, on-field performance, and complications. Between-group analyses for RTS and complications were estimated using Kaplan-Meier survival analyses. Within-group analyses for on-field performance data were performed using paired t tests with significance set at .05. Results: A total of 58 capsulolabral stabilization procedures in 54 players and 32 Latarjet procedures in 29 players were included in the analysis; 93.1% of capsulolabral patients and 96.9% of Latarjet patients returned to professional AFL. The median RTS time was 6.8 months for the capsulolabral group and 7.3 months for the Latarjet group. There was no significant difference in RTS rates between the 2 groups ( P = .270). Of those undergoing surgery early in the season, 75% of the capsulolabral and 71% of Latarjet group were able to RTS within the same season, at a mean time of 16.9 weeks and 18.8 weeks, respectively. There was a significant difference in instability recurrence, with 19% for the capsulolabral group and no recurrence in the Latarjet group ( P = .017). There was no significant reduction in player on-field performance in either group ( P < .05). Conclusion: In this study, the median RTS in AFL players was approximately 7 months after capsulolabral and Latarjet surgery with no compromise to on-field performance. Instability-related complications occurred only in the capsulolabral group, and the incidence increased with time.

Unicortical fixation does not compromise bony union in the Latarjet procedure

“…The benefits of the Latarjet procedure have been well documented, with its important role in providing GHJ stability in patients with significant bone loss, failed primary procedures, and in athletes mandating return to elite contact sport. 3,7,10,27,29 In this study, there was no significant difference in the rate of bony union between participants undergoing a Latarjet with unicortical vs. those with bicortical screw fixation. However, the absolute numbers of patients with nonunion were small, and the study was underpowered to demonstrate a statistically significant difference.…”

“…1,8,17,18,22 The risks of higher intraoperative and postoperative complications (other than recurrence) with the Latarjet than with a capsulolabral repair 40 and the possibility of early glenohumeral degenerative change 8,16 need to be weighed up against the benefit of a low rate of recurrence in the context of the individual patient presentation and functional goals. 29 In 1954, Latarjet described his procedure of transferring the coracoid process to the anterior margin of the glenoid. 21 Its stabilizing mechanism was thought to be multimodal with increase of the glenoid surface area, the sling effect of the conjoint tendon, and repair of the capsulolabral complex to the bone block.…”

Video Analysis of Pectoralis Major Injuries in Professional Australian Football Players

“…Only players who were injured and returned in season were analyzed for return-to-play timelines, as patients out of season may have significantly skewed the results and misrepresented the return-to-sport times given the long off-season period. 21 The context of any complications was also reported (ie, postsurgical complications, reinjury). The mean follow-up time for rerupture of the PM muscle was determined by the player’s return-to-sport date until the end of data collection (September 30, 2021).…”

Chronische posttraumatische Schulterinstabilität

“…Eine Vergleichsstudie (ABRK vs. LAT-Operation) im Australian Football erhob für Profis eine RTS-Rate über 90 % für beide Gruppen bei einer Rezidivrate von 0 % für LAT und von 19 % für ABRK [ 39 ].…”