Return to Sport Testing After Arthroscopic Shoulder Surgery in Adolescent and Young Adult Patients.

Abstract

Background: Readiness for return to sport (RTS) after surgery is often evaluated with strength and functional performance tests. However, relationships between RTS and patient-reported outcome measures (PROMs) after arthroscopic shoulder stabilization in adolescents and young adults is limited.

Purpose/hypothesis: The purpose of this study was to compare objective RTS testing in adolescent and young adult patients after arthroscopic shoulder stabilization with PROMs at time of testing. It was hypothesized that better PROM scores would correlate with better results in RTS testing.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Medical records of adolescent and young adult patients (13 - 21 years) who underwent arthroscopic shoulder stabilization at a single institution between 2017 and 2024 were reviewed. Data on patient demographics, operative details, PROMs [Tegner; American Shoulder and Elbow Surgeons (ASES) Shoulder Score; shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH)], and RTS testing were collected. Data for each individual RTS assessment was categorized as "pass" or "fail" based on specified criteria. A Wilcoxon rank-sum test was used to compare differences in PROMs between those patients who passed versus those who failed a given test. Multivariate regression adjusted for age and body mass index.

Results: A total of 59 patients were included (64.4% male; mean age, 16.1 ± 1.7 years); 66.1% underwent surgery on their dominant shoulder. RTS testing was performed at a mean of 6.4 ± 1.9 months postoperatively. Patients who passed the isometric external rotation strength test reported higher postoperative ASES scores (P = .04), while those who passed the isometric internal rotation strength test reported better QuickDASH scores (P = .009). Patients who passed the upper quarter Y-balance test reported significantly higher ASES (P = .005) and lower VAS (P < .05) and QuickDASH (P = .04) scores, postoperatively. Postoperative QuickDASH scores were also significantly better in those patients passing the grip strength test (P = .009). Multivariate analysis showed a 9.5-point difference in postoperative ASES scores between those who passed versus those who failed the upper quarter Y-balance test (P = .002), and a 7.1-point difference in QuickDASH scores between those who passed versus failed the grip strength test (P = .002).

Conclusion: PROMs are associated with the ability to pass some RTS assessments, suggesting their potential utility in guiding clinical decision making regarding RTS readiness.