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Player Performance, Return-to-Play, and Recurrence Rates After Operative and Nonoperative Treatment for Anterior
Peter Boufadel1, Brian S Tao1, Timothy Kouo2
1Department of Orthopaedic Surgery, Boston Medical Center, Boston, Massachusetts, USA.
Background:
Shoulder dislocation injuries may require prolonged recovery and absence from play, with risks of recurrent instability. The impact of shoulder dislocation on return-to-play (RTP) time and player performance in professional soccer athletes remains poorly defined.
Purpose:
To determine the rate and timing of RTP, risk of recurrence, and player performance after shoulder dislocation in elite professional soccer athletes.
Study Design:
Descriptive Epidemiology Study.
Methods:
Professional soccer athletes who sustained a shoulder dislocation between 2010 and 2024 across the 5 major European soccer leagues with a minimum 1-year follow-up were identified using publicly available records. Injured athletes were matched by position, age, height, season, experience, and preinjury minutes played and compared to uninjured controls. RTP rates, recurrence, field time, and performance up to 4 seasons after injury were assessed.
Results:
A total of 118 soccer athletes with shoulder dislocations were included (38% defenders, 23% attackers, 20% goalkeepers, and 19% midfielders). Mean age at time of injury was 26.2 ± 4.2 years. Overall, 87% returned to the same level within 2 seasons after shoulder dislocation. Injured athletes missed a median of 68 days and 10 games, with goalkeepers missing more days (124 vs 60, P < .001) and games (21 vs 8, P < .001) compared to outfield players. Recurrence occurred in 18% at a mean time of 2.6 ± 2.4 years, with a higher risk in athletes ≤25 years (26% vs 12%, P = .046). By treatment, 59% and 41% underwent operative and nonoperative management, respectively, with similar recurrence rates (17.1% vs 18.8%, P = .823) but longer time to recurrence in the operative group (3.82 ± 2.91 vs 1.41 ± 0.69 years, P = .009). Injured athletes played significantly fewer games, total minutes, and minutes per game during the index season and at 1 and 2 seasons after shoulder injury compared with matched controls. However, performance metrics and RTP rates in all seasons after injury remained comparable to matched controls across all positions and treatment groups.
Conclusion:
Professional soccer athletes returned to play at a high rate and a median of 68 days after shoulder dislocation, with an 18% recurrence rate. Despite reduced field time for up to 2 seasons after injury, overall player performance and RTP were not adversely affected.
