Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA.
Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA.
J Shoulder Elbow Surg. 2021 Jun;30(6):e317-e321. doi: 10.1016/j.jse.2021.01.026. Epub 2021 Feb 19.
The purpose of this study was to survey the members of North American and European shoulder surgery and sports medicine societies to evaluate their criteria for deciding when an athlete can safely return to play (RTP) following shoulder stabilization surgery.
A survey was sent to the members of the American Shoulder and Elbow Surgeons (ASES), American Orthopaedic Society for Sports Medicine (AOSSM), European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), and European Society for Surgery of the Shoulder and the Elbow (SECEC). Surgeons were asked which criteria they used to determine when an athlete can return to play following the arthroscopic Bankart repair and Latarjet procedures, with additional questions on how time from surgery and participation in collision sports affect return.
Overall, 317 surgeons responded to the survey. Following arthroscopic Bankart repair, the most common criteria used were time (98.7%), strength (74.8%), and range of motion (70%). The most commonly reported time point was 4 months (43.8%), and the majority used an additional time period, most commonly 2 months (38.2%), before allowing a collision athlete to return to play (75.4%). Interestingly, the addition of a remplissage procedure did not affect decision making regarding RTP in most cases (92.1%). Following the Latarjet procedure, the most common criteria used were time (98.4%), strength (67.5%), and range of motion (65.9%). Less than half reported using imaging to assess for radiographic union before allowing patients to return to play (47%), and the most common modality was plain radiography (80%). The most common time point was 4 months (33.1%), and the majority reported waiting an additional period of time, most commonly by 2 months (25.9%), before allowing a collision athlete to return to play (59.6%).
Despite the absence of evidence-based guidelines on when athletes can safely return to play following shoulder stabilization surgery, there exists minimal variability in recommendations between North American and European shoulder surgeons. Further research is required to better define criteria for RTP after the arthroscopic Bankart repair and Latarjet procedures.
本研究旨在调查北美和欧洲肩部外科和运动医学学会的成员，以评估他们在决定肩部稳定手术后运动员何时可以安全重返运动（RTP）的标准。
向美国肩肘外科医师协会（ASES）、美国运动医学学会（AOSSM）、欧洲运动创伤学、膝关节外科和关节镜学会（ESSKA）和欧洲肩肘外科协会（SECEC）的成员发送了一份调查。外科医生被要求使用哪些标准来确定运动员在接受关节镜下 Bankart 修复和 Latarjet 手术后何时可以重返运动，并就手术时间和参与碰撞运动如何影响回归提出了额外的问题。
共有 317 名外科医生对调查做出了回应。在接受关节镜下 Bankart 修复后，最常用的标准是时间（98.7%）、力量（74.8%）和运动范围（70%）。最常报告的时间点是 4 个月（43.8%），大多数人使用另外 2 个月（38.2%）的时间间隔，然后允许碰撞运动员重返运动（75.4%）。有趣的是，在大多数情况下（92.1%），填充物程序的添加并不会影响 RTP 的决策。在接受 Latarjet 手术后，最常用的标准是时间（98.4%）、力量（67.5%）和运动范围（65.9%）。不到一半的人报告在允许患者重返运动前使用影像学评估放射学融合（47%），最常用的方式是普通 X 线摄影（80%）。最常报告的时间点是 4 个月（33.1%），大多数人报告等待另外的时间间隔，最常见的是 2 个月（25.9%），然后允许碰撞运动员重返运动（59.6%）。
尽管在肩部稳定手术后运动员何时可以安全重返运动方面缺乏基于证据的指南，但北美和欧洲肩部外科医生的建议之间几乎没有差异。需要进一步的研究来更好地定义关节镜下 Bankart 修复和 Latarjet 手术后 RTP 的标准。
