Substantial influence of psychological factors on return to sports after anterior shoulder instability surgery: a systematic review and meta-analysis

Purpose This systematic review and meta-analysis aimed to (1) determine the proportion of patients who underwent anterior shoulder instability surgery and did not return to sports for psychological reasons and (2) estimate differences in psychological readiness scores between patients who did and di...

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Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2023-12, Vol.31 (12), p.5913-5923
Main Authors: Velasquez Garcia, Ausberto, Iida, Naoya, Kuroiwa, Tomoyuki, Hsu, Kai-Lan, de Marinis, Rodrigo, Abdo, Glen, Ekdahl, Max
Format: Article
Language:English
Subjects:
Anterior shoulder instability surgery
Athletes
Fear of reinjury
Humans
Instability
Joint Instability - surgery
Medicine
Medicine & Public Health
Meta-analysis
Orthopedics
Patients
Psychological factors
Return to Sport - psychology
Return to sports
Shoulder
Shoulder Joint - surgery
Sports - psychology
Sports Medicine
Stability
Stability analysis
Surgery
Systematic review
The shoulder instability‐return to sport after injury (SIRSI)
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Summary:Purpose This systematic review and meta-analysis aimed to (1) determine the proportion of patients who underwent anterior shoulder instability surgery and did not return to sports for psychological reasons and (2) estimate differences in psychological readiness scores between patients who did and did not return to sports. Methods The EBSCOhost/SPORTDiscus, PubMed/Medline, Scopus, EMBASE and Cochrane Library databases were searched for relevant studies. The data synthesis included the proportion of patients who did not return to sports for psychological reasons and the mean differences in the psychological readiness of athletes who returned and those who did not return to sports. Non-binomial data were analysed using the inverse-variance approach and expressed as the mean difference with 95% confidence intervals. Results The search yielded 700 records, of which 13 (1093 patients) were included. Fourteen psychological factors were identified as potential causes for not returning to sports. The rates of return to sports at any level or to the preinjury level were 79.3% and 61.9%, respectively. A total of 55.9% of the patients cited psychological factors as the primary reason for not returning to sports. The pooled estimate showed that patients who returned to sports had a significantly higher Shoulder Instability-Return to Sport After Injury score ( P  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-023-07652-0