Criteria-based return-to-sport testing helps identify functional deficits in young athletes following posterior labral repair but may not reduce recurrence or increase return to play

• Published in: JSES international 2023-05, Vol.7 (3), p.385-392
• Main Authors: Reddy, Rajiv P., Rai, Ajinkya, Como, Matthew, Sebastiani, Romano, Como, Christopher, Hyre, Nathan, Fails, Alex, Miller, Liane M., Lesniak, Bryson, Popchak, Adam, Lin, Albert
• Format: Article
• Language: English
• Subjects: Athlete; Posterior instability; Posterior labral repair; Recurrent instability; Rehabilitation; Return to sport; Shoulder; Testing
• ISSN: 2666-6383; 2666-6383
• DOI: 10.1016/j.jseint.2023.01.002

The purpose of this study was to compare recurrent instability and return to play (RTP) in young athletes who underwent clearance to full activity based on a validated return-to-sport (RTS) test to those who underwent time-based clearance following primary posterior labral repair. This was a retrospective review of athletes with posterior shoulder instability who underwent primary arthroscopic posterior labral repair from 2012 to 2021 with minimum 1-year follow-up. Patients who underwent RTS testing at a minimum of 5 months postoperatively were compared to a historic control cohort of patients who underwent time-based clearance. There were 30 patients in the RTS cohort and 67 patients in the control cohort (mean follow-up 32.1 and 38.6 months, respectively). Of the 30 patients who underwent RTS testing, 11 passed without failing any sections, 10 passed while failing 1 section, and 9 failed the RTS test by failing 2+ sections. No differences were found between the RTS and control cohort in the incidence of recurrent instability (6.7% vs. 9.0%), overall RTP (94.7% vs. 94.3%), RTP at the same level as before injury (84.2% vs. 80.0%), recurrent pain/weakness (23.3% vs. 25.4%), or revision surgery (0% vs. 3.0%), respectively. While RTS testing in young athletes after posterior labral repair did not reduce recurrence or improve return to play compared to time-based clearance, two-thirds of athletes who underwent testing failed at least 1 section, indicating some functional deficit. Thus, RTS testing may help guide postoperative rehabilitation following posterior stabilization.