Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.
The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Arthroscopy. 2018 Mar;34(3):903-913. doi: 10.1016/j.arthro.2017.08.293. Epub 2017 Nov 13.
To identify and describe in the existing literature any criteria used for return to play following surgical stabilization for traumatic, anterior shoulder instability.
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.
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.
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 IV, systematic review.
在现有的文献中确定并描述用于创伤性、前肩不稳定的手术稳定后重返赛场的任何标准。
我们进行了一项系统评价，评估了 1994 年 1 月至 2017 年 1 月在 PubMed 和 EMBASE 上使用 I 级至 IV 级研究对骨骼成熟的患者进行的原发性创伤性前肩不稳定的手术稳定后，至少有 1 年随访的患者。
从超过 5100 篇已发表文章的综述中，确定了 58 项至少有 1 项明确的重返赛场标准的研究。确定了 7 种不同类别的重返赛场标准，最常见的是手术时间（89.6%）、力量（18.9%）和运动范围（13.8%）。疼痛、稳定性、本体感觉和术后放射学评估也被使用。正如假设的那样，在纳入的 58 项研究中有 75.8%（44/58）明确使用了时间作为唯一的标准。最常使用的重返赛场时间是 6 个月。
这项系统评价确定了 7 个标准，这些标准已在现有文献中用于确定患者何时准备重返赛场；然而，与我们的假设一致，75%的研究仅使用手术时间作为唯一列出的标准，最常用的时间点是术后 6 个月。所有这些标准都可以在未来的研究中用于制定一个全面的功能标准清单，希望能减少复发性损伤。
IV 级，系统评价。
