Summary

Why Athletes don’t Return to Sports After Arthroscopic Bankart Repair? A Comparative study of 230 Athletes with a mínimum 2 Years Follow-up

Abstract

Background

There is a lack of information in the literature regarding the reasons why patients do not return to sports after an arthroscopic Bankart repair. Likewise, it is not clear whether there is a relationship between functional outcomes and complications and the rate of return to sports.

Purpose

Evaluate the reasons why competitive athletes treated with an arthroscopic Bankart repair do not return to sport and whether there is a relationship between between returning to sport and postoperative functional outcomes and complications.

Methods

Between June 2014 and December 2017, 230 athletes underwent arthroscopic Bankart repair for isolated anterior instability at our institution. Return to sports, the level achieved and the time elapsed between surgery and return to competition was assessed. We also asked patients who did not return to sports the reasons for cessation. Range of motion (ROM), the Rowe score, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences, reoperations and complications s were also evaluated.

Results

The mean follow up was 40 months (range, 24-90 months) and the mean age was 24.2 years (range, 18-30 years). Seventy-three percent of patients were able to return to sports (group 1) and 27% did not return to sports (group 20). Sixty five percent returned to their preinjury level of play. Regarding the reasons for sport cessation, 85% of the athletes reported leaving for reasons independent of their shoulder. The most frequent were fear of reinjury 44%, lack of confidence in their shoulder 12% and concern of a new rehabilitation process in case of recurrence 10%. The Rowe score, and ASSOS score showed statistical improvement after operation without significant differences between the groups at the final follow-up (P < .001). There were a total of 21 recurrences (10%) and 5 complications (2.4%). Eleven patients (5.3%) underwent revisión surgery. There were not significant difference in the rate of recurrences complications nor revisions between the two groups.

Conclusions

Although the Banakart repair produces excellent functional results in competitive athletes, a considerable number of patients do not return sports. Eighty-five percent of patients left sports for a reason independent of the shoulder. with the two most frequent causes being fear of a new injury and lack of confidence in the shoulder. Neither functional outcomes nor complications varied significantly between patients who returned and those who did not return to sport.