Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review.
Date
2021-03
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Abstract
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.Type
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Publication Info
Lau, Brian C, Lorena Bejarano Pineda, Tyler R Johnston, Bonnie P Gregory, Mark Wu, Amanda N Fletcher, Leila Ledbetter, Jonathan C Riboh, et al. (2021). Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review. Orthopaedic journal of sports medicine, 9(3). p. 2325967120982059. 10.1177/2325967120982059 Retrieved from https://hdl.handle.net/10161/30092.
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Scholars@Duke
![Lau](https://scholars.duke.edu/profile-images/thumbnail200/0903744.jpg)
Brian Chei-Fai Lau
![Ledbetter](https://scholars.duke.edu/profile-images/thumbnail200/0482013.jpg)
Leila Ledbetter
Leila is the library liaison to the School of Nursing.
As a research specialist, Leila works with faculty, staff and students to provide library services such as: systematic reviews of the literature; classes on evidence-based practice, resources and tools; research consultations; and office hours.
AHIP, Academy of Health Information Professionals Distinguished Member
MLIS, School of Information Studies, University of Wisconsin at Milwaukee
BS, Biology, Marietta College
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