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. 2023 Feb 2;7(3):385-392.
doi: 10.1016/j.jseint.2023.01.002. eCollection 2023 May.

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

Rajiv P Reddy  1 , Ajinkya Rai  1 , Matthew Como  1 , Romano Sebastiani  1 , Christopher Como  1 , Nathan Hyre  1 , Alex Fails  1 , Liane M Miller  1 , Bryson Lesniak  1 , Adam Popchak  1 , Albert Lin  1
Affiliations

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

Rajiv P Reddy et al. JSES Int. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Keywords: Athlete; Posterior instability; Posterior labral repair; Recurrent instability; Rehabilitation; Return to sport; Testing.

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Figures

Figure 1
Figure 1
Isokinetic internal and external rotation test using Biodex dynamometer.
Figure 2
Figure 2
Isometric external and internal rotation test at (A) 0 degrees and (B) 90 degrees abduction.
Figure 3
Figure 3
Closed kinetic chain Upper extremity stability test.
Figure 4
Figure 4
Unilateral seated shot-put test.
See this image and copyright information in PMC

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