Szlufcik Mike, Pasurka Mario, Theodoropoulos John, Betsch Marcel
Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
University of Toronto Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, ON, Canada.
J Orthop Surg (Hong Kong). 2024 Sep-Dec;32(3):10225536241302219. doi: 10.1177/10225536241302219.
Purpose of this study is to explore currently utilized readiness to return to sports (RTS) criteria after shoulder stabilization surgery used in elite athletes to gain novel insights into the RTS decision making process of professional team physicians. 19 qualitative semi-structured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after shoulder stabilization surgery. General inductive analysis and a coding process were used to identify themes and sub-themes arising from the data. A hierarchical approach in coding helped to link themes. We were able to identify five key themes that participating physicians focused on to determine RTS decision making: external influence, objective and subjective criteria, time elapsed since surgery and type of sport. The most important RTS criteria included: range of motion and muscle strength followed by clinical joint stability, time since surgery, ability of sporting movement, psychological readiness, functional testing, absence of pain and allied team support. This study identified several main themes and subordinate minor themes as having the most influence on RTS decision after shoulder surgery. We showed that even among specialized professional team physicians, the main criteria to RTS in these categories were inconsistent necessitating the future development of specific RTS guidelines.
本研究的目的是探讨目前精英运动员肩部稳定手术后用于恢复运动（RTS）的标准，以深入了解职业队医在RTS决策过程中的新见解。由一名经过培训的访谈者对19名职业队医进行了定性半结构化访谈。这些访谈用于确定队医关于肩部稳定手术后确定RTS所用标准的概念和主题。采用一般归纳分析和编码过程来识别数据中出现的主题和子主题。编码中的分层方法有助于将主题联系起来。我们能够确定参与访谈的医生在确定RTS决策时关注的五个关键主题：外部影响、客观和主观标准、手术后经过的时间以及运动类型。最重要的RTS标准包括：活动范围和肌肉力量，其次是临床关节稳定性、手术后时间、运动能力、心理准备、功能测试、无疼痛以及团队支持。本研究确定了几个对肩部手术后RTS决策影响最大的主要主题和从属次要主题。我们表明，即使在专业的职业队医中，这些类别中RTS的主要标准也不一致，因此有必要在未来制定具体的RTS指南。
