肩关节前路稳定术后重返竞技运动：当前结果及恢复参赛决策标准的范围综述
Return to Competitive Sport After Anterior Shoulder Stabilization: A Scoping Review of Current Outcomes and Clearance Decision-Making Criteria.
作者信息
Fails Alex, Popchak Adam
机构信息
Physical Therapy University of Pittsburgh.
出版信息
Int J Sports Phys Ther. 2025 Sep 1;20(9):1292-1310. doi: 10.26603/001c.143184. eCollection 2025.
BACKGROUND
Reported rates of return to sport at prior levels (RTSP) and recurrent instability are varied after anterior shoulder stabilization procedures and standardized criteria for clearance decision-making are lacking.
PURPOSE
To 1) describe the current state of RTSP and recurrence rates for competitive athletes undergoing the most frequently performed anterior shoulder stabilization procedures and the factors potentially associated with these outcomes and to 2) describe RTS clearance timeframes and how RTS clearance decisions were made in the included studies.
STUDY DESIGN
Scoping review.
METHODS
A systematic literature search over the past 10 years was conducted using the MEDLINE, EMBASE, and OVID databases to find articles that analyzed RTSP and recurrent instability with at least two-year follow-up in competitive athletes after common anterior shoulder stabilization procedures. The Methodological Index for Non-randomized studies (MINORS) scale was used to assess study quality.
RESULTS
Twenty-nine articles were included, analyzing a total of 2,237 shoulders in 2,187 competitive athletes. Overall, 82.3% were able to RTSP and 7.0% had recurrent instability. For those undergoing Bankart repair, the RTSP rate was 79.7% and 9.2% had recurrent instability. For the Latarjet procedure, these rates were 87.4% and 3.1%, respectively. Reported times for return ranged from 11 weeks to 8.4 months and ten unique criteria for clearance were identified by the included articles. Strength and range-of-motion (44.8% each) were the most common criteria. The average MINORS score for non-comparative studies was 8.58 ± 1.35 (maximum score of 16). For comparative studies, the average MINORS score was 14.00 ± 1.56 (maximum score of 24).
CONCLUSION
Competitive athletes may RTSP at relatively high rates after anterior shoulder stabilization. However, high-level prospective evidence is lacking and there is a need to standardize clearance decision-making processes and reporting in the literature.
LEVEL OF EVIDENCE
Level 4 (Scoping Review).
背景
在前路肩关节稳定手术之后，恢复到之前运动水平（RTSP）的报告率以及复发性不稳定情况各不相同，且缺乏用于明确决策的标准化标准。
目的
1）描述接受最常见前路肩关节稳定手术的竞技运动员的RTSP现状和复发率，以及与这些结果潜在相关的因素；2）描述恢复运动（RTS）的批准时间框架，以及在纳入研究中如何做出RTS批准决定。
研究设计
范围综述。
方法
使用MEDLINE、EMBASE和OVID数据库对过去10年进行系统的文献检索，以查找分析常见前路肩关节稳定手术后竞技运动员RTSP和复发性不稳定且至少有两年随访的文章。使用非随机研究方法学指数（MINORS）量表评估研究质量。
结果
纳入29篇文章，共分析了2187名竞技运动员的2237个肩部。总体而言，82.3%的人能够恢复到之前的运动水平，7.0%的人有复发性不稳定。接受Bankart修复术的患者，恢复到之前运动水平的比率为79.7%，复发性不稳定的比率为9.2%。对于Latarjet手术，这些比率分别为87.4%和3.1%。报告的恢复时间从11周到8.4个月不等，纳入的文章确定了10个独特的批准标准。力量和活动范围（各占44.8%）是最常见的标准。非对照研究的平均MINORS评分为8.58±1.35（满分16分）。对于对照研究，平均MINORS评分为14.00±1.56（满分24分）。
结论
竞技运动员在前路肩关节稳定手术后可能有相对较高的比率恢复到之前的运动水平。然而，缺乏高水平的前瞻性证据，需要规范文献中的批准决策过程和报告。
证据水平
4级（范围综述）。
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