Return to Sport After Arthroscopic Bankart Repair for Anterior Shoulder Instability in Contact and Non-Contact Athletes: A Systematic Review
Jayson Saleet1, Alexander Ment2, Anthony Cusano3, Hussein Abdul-Rassoul4, Emily Curry5, Robert L. Parisien6, Xinning Li7
1Boston University School of Medicine, Boston, MA; 2University of Connecticut School of Medicine, Farmington, CT; 3University of Connecticut School of Medicine, Farmington, CT; 4University of Chicago Pritzker School of Medicine, Chicago, IL; 5Boston University School of Medicine, Boston, MA; 6Icahn School of Medicine at Mount Sinai, New York City, NY; 7Boston University School of Medicine, Boston, MA
Background: Anterior shoulder instability (ASI) accounts for over 90% of shoulder dislocations and is more often seen in athletes than in the general population. The arthroscopic Bankart repair is among the most common procedures employed to treat recurrent instability. The aim of this study is to assess the rates of return to sport (RTS) and instability reoccurrence after arthroscopic Bankart repair in contact and non-contact athletes.
Methods: A systematic review was performed using PRISMA guidelines. Included studies reported arthroscopic Bankart repair to treat ASI in athletes with one-year minimum follow-up. Exclusion criteria included non-English text, multidirectional instability, revision procedures, unclear definition of contact and non-contact sports, studies with sample size <10, and review articles.
Results: Of the 1,359 screened studies, 18 (1,254 shoulders) were included. There were 700 males and 81 females. Mean age was 22.3 years (SD: 2.97, range: 13-69) with follow-up of 57.9 months (SD: 22.8, range: 12-168). Non-contact athletes were more likely to RTS (91.5%) than contact athletes (79.4%), and were also more likely to return to pre-injury level (86.0%) than contact athletes (69.9%). The complication rate among contact athletes was higher (17.4%) than among non-contact athletes (10.3%), with recurrent instability being the most common complication. Overall, 12.4% of contact athletes compared to 3.2% of non-contact athletes required a revision procedure.
Conclusion: Contact sport participants have lower rates of RTS, return to pre-injury level and poorer outcomes as compared to non-contact athletes after undergoing arthroscopic Bankart repair for ASI.
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