Michael C Ciccotti1, Usman Syed2, Ryan Hoffman3, Joseph A Abboud2, Michael G Ciccotti2, Kevin B Freedman4. 1. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A. 2. The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A. 3. Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A. 4. The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.. Electronic address: kevin.freedman@rothmaninstitute.com.
Abstract
PURPOSE: To identify and describe in the existing literature any criteria used for return to play following surgical stabilization for traumatic, anterior shoulder instability. METHODS: We performed a systematic review evaluating surgical stabilization for primary traumatic anterior shoulder instability in skeletally mature patients with a minimum of 1-year follow-up using Level I to IV studies in PubMed and EMBASE from January 1994 to January 2017. RESULTS: Fifty-eight studies with at least 1 explicitly stated criterion for return to play were identified from a review of more than 5,100 published articles. Seven different categories of return to play criteria were identified, the most common of which were time from surgery (89.6%), strength (18.9%), and range of motion (13.8%). Pain, stability, proprioception, and postoperative radiographic evaluation were also used. As hypothesized, in 75.8% of the included studies (44/58), time was the only criterion explicitly used. The most commonly used time for return to play was 6 months. CONCLUSIONS: This systematic review identifies 7 criteria that have been used in the available literature to determine when patients are ready to return to play; however, consistent with our hypothesis, 75% of studies used time from surgery as the sole listed criterion, with the most commonly used time point of 6 months postoperative. All of these criteria can be used in future research to develop a comprehensive checklist of functional criteria in hopes of reducing recurrent injury. LEVEL OF EVIDENCE: Level IV, systematic review.
PURPOSE: To identify and describe in the existing literature any criteria used for return to play following surgical stabilization for traumatic, anterior shoulder instability. METHODS: We performed a systematic review evaluating surgical stabilization for primary traumatic anterior shoulder instability in skeletally mature patients with a minimum of 1-year follow-up using Level I to IV studies in PubMed and EMBASE from January 1994 to January 2017. RESULTS: Fifty-eight studies with at least 1 explicitly stated criterion for return to play were identified from a review of more than 5,100 published articles. Seven different categories of return to play criteria were identified, the most common of which were time from surgery (89.6%), strength (18.9%), and range of motion (13.8%). Pain, stability, proprioception, and postoperative radiographic evaluation were also used. As hypothesized, in 75.8% of the included studies (44/58), time was the only criterion explicitly used. The most commonly used time for return to play was 6 months. CONCLUSIONS: This systematic review identifies 7 criteria that have been used in the available literature to determine when patients are ready to return to play; however, consistent with our hypothesis, 75% of studies used time from surgery as the sole listed criterion, with the most commonly used time point of 6 months postoperative. All of these criteria can be used in future research to develop a comprehensive checklist of functional criteria in hopes of reducing recurrent injury. LEVEL OF EVIDENCE: Level IV, systematic review.
Authors: Travis L Frantz; Joshua S Everhart; Gregory L Cvetanovich; Andrew Neviaser; Grant L Jones; Carolyn M Hettrich; Brian R Wolf; Julie Bishop; Bruce Miller; Robert H Brophy; C Benjamin Ma; Charlie L Cox; Keith M Baumgarten; Brian T Feeley; Alan L Zhang; Eric C McCarty; John E Kuhn Journal: Orthop J Sports Med Date: 2020-02-27
Authors: Rebecca Griffith; Ioanna K Bolia; Nickolas Fretes; Iain R Murray; John Meyer; Alexander E Weber; Seth C Gamradt; Frank A Petrigliano Journal: Orthop J Sports Med Date: 2021-08-07
Authors: Rebecca Griffith; Nickolas Fretes; Ioanna K Bolia; Iain R Murray; John Meyer; Alexander E Weber; Seth C Gamradt; Frank A Petrigliano Journal: Orthop J Sports Med Date: 2021-08-06
Authors: Jordan W Fried; Eoghan T Hurley; Matthew L Duenes; Amit K Manjunath; Mandeep Virk; Guillem Gonzalez-Lomas; Kirk A Campbell Journal: Arthrosc Sports Med Rehabil Date: 2020-12-24