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High Rates of Return To Play Following Surgical Stabilization for Shoulder Instability in Adolescent Athletes: A
Alexander J Hodakowski1, Eoghan T Hurley1, Juan Bernardo Villarreal-Espinosa1
1Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A.
Purpose:
To systematically review the current evidence in the literature to evaluate the rates of return to play (RTP) and subsequent recurrent instability rate after surgical stabilization of anterior shoulder instability in adolescents.
Methods:
A literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they evaluated and reported on RTP after arthroscopic Bankart repair, open Bankart repair, or Latarjet procedure in adolescent athletes. The outcomes measured focused on (1) RTP, (2) RTP at the same or higher level, and (3) recurrent instability.
Results:
Overall, 25 studies met our inclusion criteria with 1,172 patients. Among patients undergoing arthroscopic Bankart repair, a median of 66% to 100% were able to RTP, with 56% to 100% of patients able to return to the same or higher level of competition. The overall rate of recurrent instability was 0% to 57% with a subsequent dislocation rate of 0% to 22%. Among patients undergoing open Bankart repair, a median of 88% to 100% of patients were able to RTP, and a median of 62% to 100% of patients were able to return to the same or higher level. Instability recurred in 0% to 45% of patients and 0% to 24% had a recurrent redislocation event. Among patients undergoing the Latarjet procedure, a median of 72% to 94% of patients were able to RTP and 70% to 81% were able to return to the same or higher level of play. Instability recurred in 0% to 8% of patients, and recurrent dislocation occurred in 5% to 10% of patients.
Conclusions:
Adolescent patients that undergo anterior shoulder stabilization procedures RTP at high rates irrespective of the type of procedure; however, they do not return to the same level at similar rates. The Latarjet procedure results in the lowest rate of recurrent instability compared with arthroscopic or open Bankart repair.
Level Of Evidence:
Level IV, systematic review of Level III and IV studies.