Summary

Goalkeepers Have a Higher Recurrence and Return to a Lower Level of Play Compared to Field Position Soccer Players Following Arthroscopic Bankart Repair

Abstract

Background

Little attention has been paid to the playing position as a risk factor for recurrences after an Arthroscopic Bankart repair (ABR)

Purpose

The purpose of this study was to compare return to sport, functional outcomes, and recurrence after an arthroscopic Bankart repair (ABR) between goalkeepers and field positions in soccer.
Study Design: Cohort Study

Methods

A retrospective comparative cohort study was performed in soccer players who underwent an ABR between January 2017 and December 2019. The minimum clinical follow-up was 2 years postoperative. Functional outcomes included the Rowe score, visual analogue scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). The delta was calculated based on the difference between the postoperative and preoperative scores. Return to sport, level of play, recurrent instability, and revisions were evaluated according to position played.

Results

A total of 70 position players and 11 goalkeepers met the study criteria. Postoperative functional outcomes were significantly improved in both groups compared to baseline (p <0.001). However, field position group achieved more significant outcomes improvements (delta VAS -2 vs. 0 , p = 0.029 ; delta Rowe 45 vs. 30 , p = 0.045; delta ASOSS 45 vs. 40, p = 0.028) While all players returned to soccer, only 55% (n=6) of goalkeepers returned to the same level compared to 93% of field players. (p = 0.003). The overall rate of recurrent instability was 8.6 %, but was significantly higher among goalkeepers (27.2% vs 5.7%; p = 0.049). Moreover, the odds of goalkeepers having a recurrence were significantly higher than field position players (OR 8.5 95% CI 1.2-57.2, p = 0.027).

Conclusion

Although the results of ABR are generally favorable in soccer players, goalkeepers have significantly worse functional outcomes , lower rates of return to sports at the same level, and higher recurrence rates compared to field position players. This information may be useful both for preoperative counseling and modifying treatment approach based on position in soccer.