Dataset Information

Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review.

ABSTRACT: CONTEXT:Superior labral anterior-posterior (SLAP) lesions often result in significant sporting limitations for athletes. Return to sport is a significant outcome that often needs to be considered by athletes undergoing the procedure. OBJECTIVE:To evaluate return to sport among individuals undergoing arthroscopic SLAP repair. DATA SOURCES:Four databases (MEDLINE, EMBASE, PubMed, and Cochrane) were searched from database inception through January 29, 2018. STUDY SELECTION:English-language articles reporting on return-to-activity rates after arthroscopic SLAP repairs were included. STUDY DESIGN:Systematic review. LEVEL OF EVIDENCE:Level 4. DATA EXTRACTION:Data including patient demographics, surgical procedure, and return to activity were extracted. The methodological quality of included studies was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) tool. RESULTS:Of 1938 screened abstracts, 22 articles involving a total of 944 patients undergoing arthroscopic SLAP repair met inclusion criteria. Of the total included patients, 270 were identified as overhead athletes, with 146 pitchers. Across all patients, 69.6% (657/944 patients) of individuals undergoing arthroscopic SLAP repair returned to sport. There was a 69.0% (562/815 patients) return to previous level of play, with a mean time to return to sport of 8.9 ± 2.4 months (range, 6.0-11.7 months). The return-to-sport rate for pitchers compared with the return-to-activity rate for nonpitchers, encompassing return to work and return to sport, was 57.5% (84/146 patients) and 87.1% (572/657 patients), respectively, after arthroscopic SLAP repair. CONCLUSION:Arthroscopic SLAP repair is associated with a fair return to sport, with 69.6% of individuals undergoing arthroscopic SLAP repair returning to sport. SLAP repair in pitchers has significantly decreased return to sport in comparison with nonpitching athletes. Athletes on average return to sport within 9 months postoperatively.

SUBMITTER: Thayaparan A

PROVIDER: S-EPMC6822213 | biostudies-literature | 2019 Nov/Dec

REPOSITORIES: biostudies-literature

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Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review.

Thayaparan Aarabi A Yu James J Horner Nolan S NS Leroux Timothy T Alolabi Bashar B Khan Moin M

Sports health 20191004 6

<h4>Context</h4>Superior labral anterior-posterior (SLAP) lesions often result in significant sporting limitations for athletes. Return to sport is a significant outcome that often needs to be considered by athletes undergoing the procedure.<h4>Objective</h4>To evaluate return to sport among individuals undergoing arthroscopic SLAP repair.<h4>Data sources</h4>Four databases (MEDLINE, EMBASE, PubMed, and Cochrane) were searched from database inception through January 29, 2018.<h4>Study selection< ...[more]

PMID: 31584340

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Project description:PurposeTo compare clinical failure, recurrent instability, patient-reported outcome measures (PROMs), and return to sport (RTS) between knotted and knotless fixation methods in arthroscopic posterior labral repair for isolated posterior shoulder instability (PSI).MethodsMultiple databases were queried according to Preferred Reported Items for Systematic Reviews and Meta-Analyses guidelines for clinical studies with Level I to IV evidence, including knotted and knotless suture anchors for arthroscopic posterior labral repair. Combined anterior and posterior instability, multidirectional instability, SLAP injuries, unspecified repair techniques, majority open procedures, and revision surgery were excluded.ResultsScreening yielded 17 full-text articles reporting on 852 shoulders undergoing posterior labral repair. Recurrent instability ranged from 0% to 21%, and the rate of revision surgery ranged from 0% to 11% in knotted only, 0% in knotless only, and 2.0% to 8.1% in knotted and knotless studies. Six studies with both pre- and postoperative visual analog scale scores and 7 studies with both pre- and postoperative American Shoulder and Elbow Score scores all showed improvement in scores after intervention regardless of repair technique. Thirteen studies reported RTS or duty rates with a minimum of 79%.ConclusionsOverall recurrent instability after posterior labral repair for isolated PSI was low with improvement in PROMs and favorable RTS rates regardless of fixation method. There was no clear difference in recurrent instability or revision surgery between knotted and knotless fixation methods for isolated posterior labral repair. However, the current literature is predominantly limited by Level III and IV evidence. The quality of literature and lack of standardization on the definition of clinical failure and recurrent instability among surgeons preclude any definitive conclusion regarding one clinically superior fixation method.Level of evidenceLevel IV, systematic review of Level III and IV studies.

Project description:CONTEXT::Pectoralis major tendon ruptures are becoming increasingly common due to the growing prevalence of active lifestyles. Studies investigating the efficacy of pectoralis major tendon repair have limited sample sizes and offer mixed results, while existing reviews do not explore postoperative activity outcomes for patients. OBJECTIVE::To summarize and synthesize the clinical outcomes and rate of return to activity after isolated pectoralis major tendon repair. DATA SOURCES::Four databases (MEDLINE, EMBASE, PubMed, and CINAHL) were searched from database inception through March 7, 2018. STUDY SELECTION::Studies reporting outcomes of isolated pectoralis major tendon repair for pectoralis major tendon rupture were included. STUDY DESIGN::Systematic review. LEVEL OF EVIDENCE::Level 4. DATA EXTRACTION::Data including patient demographics, intervention details, and clinical outcomes were extracted. The methodological quality of included studies was evaluated. RESULTS::Of 2332 retrieved articles, 18 studies were included, with a total of 536 patients. A majority (90%; 134/149) of patients undergoing pectoralis major tendon repair successfully returned to sport at a mean 6.1 ± 1.7 months postsurgery, of which 74% (95/128) successfully returned to their preinjury level of sport. The majority (95%; 269/284) of patients returned to work at a mean 6.9 ± 1 months. Postsurgically, 81% (83/102) of patients experienced complete pain relief after the surgery, and 19% (21/109) had cosmetic complaints after pectoralis major repair. Of the 10 studies that reported complications, 18% (75/423) of patients had postoperative complications, including reruptures and wound infections; 7% (30/423) of patients required reoperation for their complications. CONCLUSION::Pectoralis major tendon repair is an effective treatment that results in a high rate of return to sport and work, pain relief, and improved cosmetic appearance, albeit with a significant rate of complication. The evidence supporting all outcomes was limited by the rarity of the injury, the variable surgical techniques, and outcome assessment criteria.

Dataset Information

Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review.

Publications

Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review.

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