Effect of Playing Position on Return to Sport, Functional Outcomes, and Recurrence After Arthroscopic Bankart Repair in Soccer Players.

Abstract

Little attention has been paid to playing position as a risk factor for recurrence after arthroscopic Bankart repair (ABR) in soccer players. To compare return to sport, functional outcomes, and recurrence after ABR between goalkeepers and field position players in soccer. Cohort study; Level of evidence, 3. A retrospective comparative cohort study was performed in soccer players who underwent ABR between January 2017 and December 2019. The minimum clinical follow-up was 2 years. Functional outcomes included the Rowe score, visual analog scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). The difference between the post- and preoperative scores was calculated; rate and level of return to sport, recurrent instability, and revisions were also evaluated according to position played. A total of 70 position players and 11 goalkeepers met the study criteria. Postoperative functional outcomes were significantly improved in both groups as compared with baseline (P < .001 for both), although the position players achieved significantly greater pre- to postoperative improvement (ΔVAS, -2 vs 0 points [P = .029]; ΔRowe, 45 vs 30 points [P = .046]; ΔASOSS, 45 vs 40 points [P = .028]). While all players returned to soccer, only 55% (n = 6) of goalkeepers returned to the same level versus 93% of field players (P = .003). The overall rate of recurrent instability was 8.6% but was significantly higher among goalkeepers (27.2% vs 5.7%; P = .049), and the odds of goalkeepers having a recurrence were significantly higher than field position players (odds ratio, 8.5 [95% CI, 1.2-57.2]; P = .027). Although the results of ABR were generally favorable in all soccer players, goalkeepers had significantly worse functional outcomes, a lower rate of return to the same level of sport, and a higher recurrence rate as compared with field position players.