Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis
Purpose: To assess clinical outcomes of primary arthroscopic repair for unilateral posterior shoulder instability (PSI) in all patients, to evaluate clinical outcomes in athletes, and to compare clinical outcomes between contact and overhead athletes. Methods: A systematic review was performed using...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X24001755 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850183026861932544 |
|---|---|
| author | Antonio Cusano, M.D. Alexander J. Ment, B.A. Kevin A. Hao, M.D. Jayson Saleet, B.A. Patrick Nian, B.A. Emily Curry, M.P.H. Michael Groot, M.S. David Novikov, M.D. Hussein Abdul-Rassoul, M.D. Robert L. Parisien, M.D. Brett D. Owens, M.D. Xinning Li, M.D. |
| author_facet | Antonio Cusano, M.D. Alexander J. Ment, B.A. Kevin A. Hao, M.D. Jayson Saleet, B.A. Patrick Nian, B.A. Emily Curry, M.P.H. Michael Groot, M.S. David Novikov, M.D. Hussein Abdul-Rassoul, M.D. Robert L. Parisien, M.D. Brett D. Owens, M.D. Xinning Li, M.D. |
| author_sort | Antonio Cusano, M.D. |
| collection | DOAJ |
| description | Purpose: To assess clinical outcomes of primary arthroscopic repair for unilateral posterior shoulder instability (PSI) in all patients, to evaluate clinical outcomes in athletes, and to compare clinical outcomes between contact and overhead athletes. Methods: A systematic review was performed using PRISMA Guidelines. Included studies reported on primary arthroscopic treatment of PSI with at least 1 year of follow-up. Studies were excluded if they were not in English, included revisions/open procedures or anterior/multidirectional instability, had fewer than 10 patients or no full text available, or were biomechanical analyses/descriptions of surgical technique. Primary outcomes were rates of return to sport (RTS), return to preinjury level (RTPL), recurrent instability, and revision surgery. Outcomes were evaluated in all patients and all athletes, with further subdivision for contact and overhead. Results: Of the 1,504 screened studies, 30 met inclusion criteria (1,649 shoulders). Mean age at surgery was 23.3 years (range: 12.4–65 years), and mean follow-up was 35.5 months (range: 12–140.4 months). There were 1,051 males and 196 females. RTS rates were 91.7% among all patients and 90.9% in all athletes, with no statistical difference between contact and overhead athletes (92.8% vs 88.1%; P = .176). RTPL rates were 78.7% among all patients and 75.6% in all athletes, with no statistical difference between contact and overhead athletes (90.8% vs 62.3%; P = .072). Recurrent instability rates were 7.0% among all patients and 8.0% in all athletes, with no statistical difference between contact and overhead athletes (7.3% vs 7.4%; P = .981). Revision rates were 3.7% among all patients and 3.3% in all athletes, with no statistical difference between contact and overhead athletes (6.8% vs. 0%; P = 1). Conclusion: Primary arthroscopic treatment of PSI is associated with favorable outcomes and high return to sport and work rates. Recurrent instability and pain were the most common reasons for revision. Level of Evidence: Level IV, Systematic review and meta-analysis of Level II to IV studies. |
| format | Article |
| id | doaj-art-902f82196d4f445db199d61eb0aa00a9 |
| institution | OA Journals |
| issn | 2666-061X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj-art-902f82196d4f445db199d61eb0aa00a92025-08-20T02:17:28ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2025-04-017210103210.1016/j.asmr.2024.101032Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-AnalysisAntonio Cusano, M.D.0Alexander J. Ment, B.A.1Kevin A. Hao, M.D.2Jayson Saleet, B.A.3Patrick Nian, B.A.4Emily Curry, M.P.H.5Michael Groot, M.S.6David Novikov, M.D.7Hussein Abdul-Rassoul, M.D.8Robert L. Parisien, M.D.9Brett D. Owens, M.D.10Xinning Li, M.D.11Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.; Address correspondence to Antonio Cusano, M.D., University of Connecticut/UConn Health, Farmington, CT, U.S.A.Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, U.S.A.Department of Orthopaedic Surgery, Boston University Medical School and Medical Center, Boston, Massachusetts, U.S.A.Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A.Department of Orthopaedic Surgery, Boston University Medical School and Medical Center, Boston, Massachusetts, U.S.A.Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.Department of Orthopaedic Surgery, Boston University Medical School and Medical Center, Boston, Massachusetts, U.S.A.Department of Orthopaedic Surgery, University of Chicago, Chicago, Illinois, U.S.A.Department of Orthopaedic Surgery, Mount Sinai. New York, New York, U.S.A.Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.Department of Orthopaedic Surgery, Boston University Medical School and Medical Center, Boston, Massachusetts, U.S.A.Purpose: To assess clinical outcomes of primary arthroscopic repair for unilateral posterior shoulder instability (PSI) in all patients, to evaluate clinical outcomes in athletes, and to compare clinical outcomes between contact and overhead athletes. Methods: A systematic review was performed using PRISMA Guidelines. Included studies reported on primary arthroscopic treatment of PSI with at least 1 year of follow-up. Studies were excluded if they were not in English, included revisions/open procedures or anterior/multidirectional instability, had fewer than 10 patients or no full text available, or were biomechanical analyses/descriptions of surgical technique. Primary outcomes were rates of return to sport (RTS), return to preinjury level (RTPL), recurrent instability, and revision surgery. Outcomes were evaluated in all patients and all athletes, with further subdivision for contact and overhead. Results: Of the 1,504 screened studies, 30 met inclusion criteria (1,649 shoulders). Mean age at surgery was 23.3 years (range: 12.4–65 years), and mean follow-up was 35.5 months (range: 12–140.4 months). There were 1,051 males and 196 females. RTS rates were 91.7% among all patients and 90.9% in all athletes, with no statistical difference between contact and overhead athletes (92.8% vs 88.1%; P = .176). RTPL rates were 78.7% among all patients and 75.6% in all athletes, with no statistical difference between contact and overhead athletes (90.8% vs 62.3%; P = .072). Recurrent instability rates were 7.0% among all patients and 8.0% in all athletes, with no statistical difference between contact and overhead athletes (7.3% vs 7.4%; P = .981). Revision rates were 3.7% among all patients and 3.3% in all athletes, with no statistical difference between contact and overhead athletes (6.8% vs. 0%; P = 1). Conclusion: Primary arthroscopic treatment of PSI is associated with favorable outcomes and high return to sport and work rates. Recurrent instability and pain were the most common reasons for revision. Level of Evidence: Level IV, Systematic review and meta-analysis of Level II to IV studies.http://www.sciencedirect.com/science/article/pii/S2666061X24001755 |
| spellingShingle | Antonio Cusano, M.D. Alexander J. Ment, B.A. Kevin A. Hao, M.D. Jayson Saleet, B.A. Patrick Nian, B.A. Emily Curry, M.P.H. Michael Groot, M.S. David Novikov, M.D. Hussein Abdul-Rassoul, M.D. Robert L. Parisien, M.D. Brett D. Owens, M.D. Xinning Li, M.D. Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis |
| title_full | Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis |
| title_fullStr | Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis |
| title_short | Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis |
| title_sort | arthroscopic repair for posterior shoulder instability is associated with favorable outcomes and high return to sport or work a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X24001755 |
| work_keys_str_mv | AT antoniocusanomd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT alexanderjmentba arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT kevinahaomd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT jaysonsaleetba arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT patricknianba arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT emilycurrymph arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT michaelgrootms arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT davidnovikovmd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT husseinabdulrassoulmd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT robertlparisienmd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT brettdowensmd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis AT xinninglimd arthroscopicrepairforposteriorshoulderinstabilityisassociatedwithfavorableoutcomesandhighreturntosportorworkasystematicreviewandmetaanalysis |