2021 ISAKOS Biennial Congress ePoster
Return To Sport After Surgical Management Of Posterior Shoulder Instability: A Systematic Review And Meta-Analysis
Kyle Gouveia, MD, Hamilton, ON CANADA
Jeffrey Kay, MD, Toronto, ON CANADA
Muzammil Memon, MD, Hamilton, ON CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
Asheesh Bedi, MD, Ann Arbor, MI UNITED STATES
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA
McMaster University, Hamilton, Ontario, CANADA
FDA Status Not Applicable
Summary
Meta-analysis of return to sport rates following surgical management of posterior shoulder instability reveals a high overall rate of return to sport (88% [95% CI, 84%-92%]), as well as rate of return to sport at the pre-injury level (68% [95% CI, 60%-76%]).
ePosters will be available shortly before Congress
Abstract
Background
Posterior shoulder instability accounts for a small proportion of all shoulder instability, though it can affect athletes of all types; from contact to overhead athletes. Surgical treatment is quite successful in these patients; however the literature reports a wide range of rates of return to sport.
Purpose
The purpose of this systematic review was to determine the return to sport rates following surgical stabilization for posterior shoulder instability. It was hypothesized that patients would experience a high rate of return to sport.
Methods
The databases EMBASE, PubMed, and MEDLINE were searched for relevant literature from database inception until April 2020 and studies were screened by two reviewers independently and in duplicate for studies reporting rates of return to sport following surgical management of posterior shoulder instability. Demographic data as well as data on return to sport and functional outcomes were recorded. A meta-analysis of proportions was used to combine the rates of return to sport using a random effects model. A risk of bias assessment was performed for all included studies.
Results
Overall, 32 studies met inclusion criteria and comprised 1100 patients (1153 shoulders) with a mean age of 22.8 years (range 11-65) and a mean follow-up of 43.2 months (range 10-228). The pooled rate of return to any level of sport was 88% (95% CI, 84%-92%; I2=68.7%). In addition, the pooled rate of return to the preinjury level was 68% (95% CI, 60%-76%; I2=79%). Moreover, the pooled return to sport rate for contact athletes was 94% (95% CI, 90%-97%; I2=0%), while for throwing athletes it was 88% (95% CI, 83%-92%; I2= 0%).
Conclusion
Surgical management of posterior shoulder instability resulted in a high rate of return to sport, as well as significant pain reduction and functional improvement in most patients. However, only approximately two-thirds of athletes can return to their pre-injury level of sport.