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Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review

BACKGROUND: Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients. PURPOSE: To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, o...

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Autores principales: Lau, Brian C., Pineda, Lorena Bejarano, Johnston, Tyler R., Gregory, Bonnie P., Wu, Mark, Fletcher, Amanda N., Ledbetter, Leila, Riboh, Jonathan C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940729/
https://www.ncbi.nlm.nih.gov/pubmed/33748304
http://dx.doi.org/10.1177/2325967120982059
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author Lau, Brian C.
Pineda, Lorena Bejarano
Johnston, Tyler R.
Gregory, Bonnie P.
Wu, Mark
Fletcher, Amanda N.
Ledbetter, Leila
Riboh, Jonathan C.
author_facet Lau, Brian C.
Pineda, Lorena Bejarano
Johnston, Tyler R.
Gregory, Bonnie P.
Wu, Mark
Fletcher, Amanda N.
Ledbetter, Leila
Riboh, Jonathan C.
author_sort Lau, Brian C.
collection PubMed
description BACKGROUND: Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients. PURPOSE: To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score. RESULTS: Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72). CONCLUSION: Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization.
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spelling pubmed-79407292021-03-18 Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review Lau, Brian C. Pineda, Lorena Bejarano Johnston, Tyler R. Gregory, Bonnie P. Wu, Mark Fletcher, Amanda N. Ledbetter, Leila Riboh, Jonathan C. Orthop J Sports Med Article BACKGROUND: Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients. PURPOSE: To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score. RESULTS: Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72). CONCLUSION: Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization. SAGE Publications 2021-03-04 /pmc/articles/PMC7940729/ /pubmed/33748304 http://dx.doi.org/10.1177/2325967120982059 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Lau, Brian C.
Pineda, Lorena Bejarano
Johnston, Tyler R.
Gregory, Bonnie P.
Wu, Mark
Fletcher, Amanda N.
Ledbetter, Leila
Riboh, Jonathan C.
Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title_full Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title_fullStr Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title_full_unstemmed Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title_short Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review
title_sort return to play after revision anterior shoulder stabilization: a systematic review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940729/
https://www.ncbi.nlm.nih.gov/pubmed/33748304
http://dx.doi.org/10.1177/2325967120982059
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