Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Research

Background:

• Anterior shoulder instability significantly impacts young athletes.
• Surgical treatment options for anterior shoulder instability include open stabilization, arthroscopic Bankart repair with suture anchors, and the Bristow-Latarjet procedure.
• The optimal surgical technique for return to play remains debated.

Purpose of the Study:

• To systematically review and compare return-to-play rates after arthroscopic Bankart repair, Bristow-Latarjet procedure, and open stabilization for anterior shoulder instability.
• To evaluate clinical outcomes associated with each surgical technique.

Main Methods:

• Systematic review and meta-analysis of studies reporting return to play and clinical outcomes.
• Inclusion of English-language studies on primary arthroscopic Bankart repair, Latarjet procedure, or open stabilization.
• Statistical analysis using Student t tests and analyses of variance.

Main Results:

• Sixteen studies involving 1036 patients were analyzed.
• Arthroscopic Bankart repair (71%) and Latarjet procedure (73%) showed higher rates of return to preinjury level of sport compared to open stabilization (66%).
• The Latarjet procedure had a significantly lower rate of recurrent dislocation (3.5%) compared to arthroscopic Bankart repair (6.6%) and open stabilization (6.7%).

Conclusions:

• Arthroscopic Bankart repair and the Latarjet procedure are associated with a greater rate of return to preinjury level of sport for athletes with anterior shoulder instability.
• Despite differences, all surgical options result in over 65% of athletes returning to their preinjury level.
• Arthroscopic Bankart repair, Latarjet procedure, and open stabilization are all viable surgical options for athletes with anterior shoulder instability.