Velasquez Garcia Ausberto, Caballero Gabriel, Chaney Grace K, Marinakis Katina, Orizola Alejandro
Department of Orthopedic Surgery, Clinica Universidad de los Andes, Santiago, Chile.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Clin J Sport Med. 2025 Mar 1;35(2):224-234. doi: 10.1097/JSM.0000000000001280. Epub 2024 Oct 15.
Despite excellent functional outcomes after shoulder stabilization surgery, a substantial number of patients fail to return to sports (RTS) at the preinjury level. The psychological factors affecting RTS postsurgery have been underexplored. This scoping review aimed to identify and analyze potential psychological factors influencing the decision to RTS after shoulder stabilization surgery.
We reviewed the EBSCOhost/SPORTDiscus, PubMed/Medline, Scopus, EMBASE, and Cochrane Library databases for studies on patients with anterior glenohumeral instability who underwent stabilization surgery. We included studies that reported on RTS and considered the psychological factors influencing the decision to return.
Our analysis comprised 21 articles involving 2073 patients. Psychological factors influencing RTS after surgery were categorized within the framework of transactional stress and coping model. Primary appraisal factors, such as fear of reinjury, kinesiophobia, and anxiety, emerged as significant influencers. In addition, we explored factors related to social support, self-determination, motivation, competing interests, and advanced age. Assessment tools were used to evaluate the psychological readiness for RTS.
This scoping review identified fear of reinjury and kinesiophobia as important psychological barriers to returning to sports after shoulder stabilization surgery. The limited use of psychological assessment tools and lack of comparative studies have restricted robust conclusions.
Level IV, Scoping review.
尽管肩关节稳定手术后功能恢复良好，但仍有相当数量的患者未能恢复到伤前的运动水平。影响术后恢复运动的心理因素尚未得到充分研究。本综述旨在识别和分析影响肩关节稳定手术后恢复运动决策的潜在心理因素。
我们检索了EBSCOhost/SPORTDiscus、PubMed/Medline、Scopus、EMBASE和Cochrane图书馆数据库，以查找有关接受稳定手术的前盂肱关节不稳患者的研究。我们纳入了报告恢复运动情况并考虑了影响恢复运动决策的心理因素的研究。
我们的分析包括21篇文章，涉及2073名患者。影响术后恢复运动的心理因素在交易性应激与应对模型的框架内进行了分类。诸如再次受伤恐惧、运动恐惧症和焦虑等初级评估因素成为了重要的影响因素。此外，我们还探讨了与社会支持、自我决定、动机、竞争利益和高龄相关的因素。使用评估工具来评估恢复运动的心理准备情况。
本综述确定再次受伤恐惧和运动恐惧症是肩关节稳定手术后恢复运动的重要心理障碍。心理评估工具使用有限以及缺乏比较研究限制了得出有力的结论。
四级，综述。
