Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada.
Am J Sports Med. 2022 Mar;50(3):845-857. doi: 10.1177/03635465211011161. Epub 2021 May 11.
Posterior shoulder instability accounts for a small proportion of all shoulder instability, although it can affect athletes of all types, from contact to overhead athletes. Surgical treatment is quite successful in these patients; however, the literature reports a wide range of rates of return to sport.
PURPOSE/HYPOTHESIS: The purpose was to determine the return-to-sport rates after surgical stabilization for posterior shoulder instability. It was hypothesized that patients would experience a high rate of return to sport.
Systematic review and meta-analysis; Level of evidence, 4.
Embase, PubMed, and MEDLINE were searched for relevant literature from database inception until April 2020, and studies were screened by 2 reviewers independently and in duplicate for studies reporting rates of return to sport after surgical management of posterior shoulder instability. Demographic data as well as data on return to sport and functional outcomes were recorded. A meta-analysis of proportions was used to combine the rates of return to sport using a random effects model. A risk of bias was assessed for all included studies.
Overall, 32 studies met inclusion criteria and comprised 1100 patients (1153 shoulders) with a mean age of 22.8 years (range, 11-65) and a mean follow-up of 43.2 months (range, 10-228). The pooled rate of return to any level of sport was 88% (95% CI, 84%-92%; = 68.7%). In addition, the pooled rate of return to the preinjury level was 68% (95% CI, 60%-76%; = 79%). Moreover, the pooled return-to-sport rate for contact athletes was 94% (95% CI, 90%-97%; = 0%), while for throwing athletes it was 88% (95% CI, 83%-92%; = 0%).
Surgical management of posterior shoulder instability resulted in a high rate of return to sport, as well as significant pain reduction and functional improvement in most patients. However, only two-thirds of athletes can return to their preinjury levels of sport.
尽管后肩不稳定仅占所有肩不稳定的一小部分，但它会影响各种类型的运动员，包括接触性和过顶运动员。手术治疗在这些患者中非常成功；然而，文献报道的重返运动率差异很大。
目的/假设：目的是确定后肩不稳定手术后重返运动的比率。假设患者将有很高的重返运动率。
系统评价和荟萃分析；证据水平，4 级。
从数据库建立到 2020 年 4 月，通过 Embase、PubMed 和 MEDLINE 搜索有关后肩不稳定手术后运动恢复率的相关文献，由 2 名审查员独立且重复筛选报告后肩不稳定手术治疗后运动恢复率的研究。记录人口统计学数据以及重返运动和功能结果数据。使用随机效应模型对比例进行荟萃分析以合并运动恢复率。对所有纳入的研究进行风险偏倚评估。
总体而言，32 项研究符合纳入标准，共纳入 1100 名患者（1153 个肩膀），平均年龄为 22.8 岁（范围，11-65 岁），平均随访时间为 43.2 个月（范围，10-228 个月）。任何运动水平的总体运动恢复率为 88%（95%CI，84%-92%； = 68.7%）。此外，恢复到受伤前运动水平的总体运动恢复率为 68%（95%CI，60%-76%； = 79%）。此外，接触性运动员的总体运动恢复率为 94%（95%CI，90%-97%； = 0%），而投掷运动员的运动恢复率为 88%（95%CI，83%-92%； = 0%）。
后肩不稳定的手术治疗导致了很高的运动恢复率，大多数患者的疼痛显著减轻，功能明显改善。然而，只有三分之二的运动员可以恢复到受伤前的运动水平。
