Similar Rate of Return to Sport and Reoperation but Higher Rate of Recurrent Instability in Contact Versus Noncontact Athletes After Primary Arthroscopic Anterior Bankart Repair: A Systematic Review and Meta-analysis

Jayson Saleet, Kevin A. Hao, Khalid Al-Hourani, Alexander J. Ment, Ross A. Clarke, Patrick Nian, Emily J. Curry, Hussein Abdul-Rassoul, Antonio Cusano, Robert L. Parisien, Xinning Li
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Abstract

Background: Anterior shoulder instability (ASI) is often seen in both contact and noncontact athletes, and the arthroscopic Bankart repair (ABR) procedure is among the most utilized procedures to treat patients with this condition. There is a lack of large studies comparing the return to sport (RTS), outcome, and recurrence rates after ABR in contact and noncontact athletes. Purpose: To understand the differences in postoperative RTS, outcomes, and complications in contact and noncontact athletes after primary ABR for ASI. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies reported primary ABR without remplissage to treat ASI in athletes with a 1-year minimum follow-up. Random-effects meta-analysis was performed to compare outcomes. Results: Of the 1575 screened studies, 31 studies (2387 shoulders) were included. The mean age was 23.3 years (range, 13-50 years; SD, 2.97 years), 89% of the athletes were male, and the mean follow-up was 55.1 months (range, 12-107 months; SD, 22.8 months). Contact and noncontact athletes had similar rates of RTS (79% [95% CI, 63%-89%] and 91% [95% CI, 82%-96%], respectively; P = .079) and return to preinjury level (71% [95% CI, 56%-82%] and 79% [95% CI, 73%-85%], respectively; P = .201). Contact and noncontact athletes also demonstrated similar rates of revision surgery (6% [95% CI, 3%-13%] and 4% [95% CI, 3%-7%], respectively; P = .334). Contact athletes, however, exhibited a significantly higher rate of recurrent instability than noncontact athletes (17% [95% CI, 10%-27%] vs 8% [95% CI, 6%-12%]; P = .023). Conclusion: Compared with noncontact athletes, contact athletes demonstrate similar rates of RTS, return to preinjury level of play, and need for revision surgery but a higher rate of recurrent instability after primary ABR for ASI.
初次关节镜前Bankart修复后,接触性运动员与非接触性运动员的运动恢复率和再手术率相似,但复发性不稳定率更高:一项系统回顾和荟萃分析
背景:肩关节前部不稳定(ASI)常见于接触性和非接触性运动员,关节镜下Bankart修复(ABR)手术是治疗这种疾病患者最常用的手术之一。目前缺乏比较接触性和非接触性运动员ABR后运动恢复(RTS)、结果和复发率的大型研究。目的:了解接触性和非接触性运动员在ASI原发性ABR术后RTS、结局和并发症的差异。研究设计:系统评价和荟萃分析;证据等级,4级。方法:采用PRISMA(系统评价和荟萃分析首选报告项目)指南进行系统评价。纳入的研究报告了原发性ABR治疗ASI的运动员,随访时间至少为1年。采用随机效应荟萃分析比较结果。结果:在1575项筛选研究中,31项研究(2387例)被纳入。平均年龄23.3岁(年龄范围13 ~ 50岁;SD, 2.97年),89%的运动员为男性,平均随访55.1个月(范围12-107个月;SD, 22.8个月)。接触性和非接触性运动员的RTS发生率相似(分别为79% [95% CI, 63%-89%]和91% [95% CI, 82%-96%];P = 0.079)和恢复到损伤前水平(分别为71% [95% CI, 56%-82%]和79% [95% CI, 73%-85%];P = .201)。接触性和非接触性运动员也表现出相似的翻修手术率(分别为6% [95% CI, 3%-13%]和4% [95% CI, 3%-7%];P = .334)。然而,接触性运动员的复发性不稳定率明显高于非接触性运动员(17% [95% CI, 10%-27%] vs 8% [95% CI, 6%-12%];P = .023)。结论:与非接触运动员相比,接触运动员表现出相似的RTS率,恢复到损伤前的比赛水平,需要翻修手术,但ASI原发性ABR后复发性不稳定率更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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