Return to Play After Arthroscopic Stabilization for Posterior Shoulder Instability-A Systematic Review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Research

Background:

• Arthroscopic posterior shoulder stabilization is a common procedure for athletes experiencing posterior instability.
• Understanding return to play (RTP) rates and criteria is crucial for athlete recovery and performance.
• Existing literature lacks comprehensive data on specific RTP timelines and criteria following this surgery.

Purpose of the Study:

• To determine the rate and timing of return to play (RTP) after arthroscopic posterior shoulder stabilization.
• To assess the availability and reporting of specific criteria for safe RTP in the scientific literature.

Main Methods:

• A systematic review was conducted using Medline, EMBASE, and the Cochrane Library.
• Studies reporting RTP data or rehabilitation protocols for arthroscopic posterior shoulder stabilization were included.
• Studies were excluded if concomitant procedures confounded rehabilitation protocols; Level of Evidence IV (systematic review of level II-IV studies).

Main Results:

• The review included 25 studies with 895 patients; RTP rates ranged from 62.7% to 100%.
• Return to the same level of play varied, with collision athletes showing higher rates (69.2%-100%) than overhead athletes (55.6%-100%).
• RTP timing averaged 4.3 to 8.6 months, and 60% of studies reported RTP criteria, primarily strength restoration (44%).

Conclusions:

• High RTP rates are observed after arthroscopic posterior shoulder stabilization, with a typical window of 4.3 to 8.6 months.
• Collision athletes demonstrate a better return to preinjury level compared to overhead athletes.
• There is a significant deficit in reporting standardized RTP criteria, hindering the establishment of safe return-to-sport guidelines.