Analysis of reasons for failure to return to sport after Latarjet surgery: a systematic review

Abstract

BackgroundThe purpose of this study was to perform a systematic review of the literature to identify Shoulder Instability Return to Sport after Injury (SIRSI) scores in athletes who underwent open Latarjet surgery, determine the reasons why athletes failed to return to play (RTP) after Latarjet surgery and compare SIRSI scores of those who did vs. did not RTP. MethodsAccording to PRISMA guidelines and PubMed, SportDiscus, and Ovid Medline, databases were queried to identify studies evaluating return to sport after Latarjet surgery. Study quality was assessed using the MINORS criteria. Studies were included if RTP after Latarjet surgery and a psychological factor were evaluated, with potential psychological factors including readiness to RTP and reasons for failure to RTP. ResultsFourteen studies, 10 of level 3 evidence and 4 of level 4 evidence, with 1,034 patients were included. 978 athletes were eligible to RTP. Of these, 792 (79%) successfully RTP and 447 (56.4%) RTP at their previous level of play. Mean RTP time was 6.2 months. Postoperative SIRSI scores averaged 71.2 ± 8.8 at a mean of 21 months follow-up. Postoperative SIRSI scores for those who RTP was 73.2 while athletes unable to RTP scored an average of 41.5. Mean postoperative SIRSI scores for those in contact sports was 71.4, while those in non-contact sports was 86.5. There were 31 athletes with a documented reason why they did not RTP, postoperative shoulder injury being the most common reason (54.5%). Fear of reinjury and feeling ‘not psychologically confident’ each represented 6.5% of the total. ConclusionAthletes who RTP have higher average SIRSI scores than that who are unable to RTP. Of the athletes that documented why they did not RTP more than half cited a shoulder injury as their reason for not returning to play, while fear of reinjury and lack of psychological readiness were other common reasons.