Atraumatic shoulder instability: patient characteristics, comorbidities, and disability

Background The present study aimed to evaluate the methodological quality and determine the quality of reporting of randomized controlled trials (RCTs) that assess surgical treatment for shoulder instability. Methods A Cochrane, Pubmed, EMBASE and Trip database search was performed, including the relevant literature, regarding RCTs that report on shoulder instability published between January 1994 and January 2017. Methodological quality was assessed with a modification of the Checklist to Evaluate A Report of a Nonpharmacologic Trial (CLEAR-NPT). Points were assigned based on 18 items regarding patient characteristics, randomization, care provider characteristics, surgical details and blinding, with a total score ranging from 0 points to 18 points. Missing items were verified with the corresponding authors of the studies. Quality of reporting corresponds to the total scores including the items that were additionally provided by the authors. Results We included 22 studies. Of these, nine corresponding authors provided additional information. The average methodological quality was 16.9 points (11 studies) and the average quality of reporting was 9.5 points (22 studies). Items scoring worst included information regarding the surgeon’s experience, the patients’ level of activity, comorbidities, analyzing according to ‘intention-to-treat’ principles, and blinding of care providers, participants and assessors. Conclusions RCTs reporting on shoulder instability surgery are well performed but poorly reported.

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Direct and indirect costs associated with nonoperative treatment for shoulder instability: an observational study in 132 patients

Shoulder & Elbow ◽

10.1177/1758573218773543 ◽

2018 ◽

Vol 11 (4) ◽

pp. 265-274 ◽

Cited By ~ 2

Author(s):

Just A van der Linde ◽

Judith E Bosmans ◽

Dirk P ter Meulen ◽

Derk A van Kampen ◽

Derek FP van Deurzen ◽

...

Keyword(s):

Observational Study ◽

Healthcare Utilization ◽

Shoulder Instability ◽

Patient Characteristics ◽

Nonoperative Treatment ◽

Mean Difference ◽

Level Of Evidence ◽

Societal Costs ◽

Productivity Losses ◽

Healthcare Expenses

Background Shoulder instability is associated with decreased functioning. The associated costs could be substantial and interesting to clinicians, researchers, and policy makers. This prospective observational study aims to (1) estimate productivity losses and healthcare expenses following the nonoperative treatment of shoulder instability and (2) identify patient characteristics that influence societal costs. Methods One hundred and thirty-two patients completed a questionnaire regarding production losses and healthcare utilization following consecutive episodes of shoulder instability. Productivity losses were calculated using the friction cost approach. Healthcare utilization was evaluated using standard costs. analysis of variance test was used to assess which patient characteristics are related to productivity losses and healthcare expenses. Societal costs were assessed using multilevel analyses. Bootstrapping was used to estimate statistical uncertainty. Results Mean productivity losses are €1469, €881, and €728 and mean healthcare expenses are €3759, €3267, and €2424 per patient per dislocation for the first, second, and third dislocation. Productivity losses decrease significantly after the second (mean difference €−1969, 95%CI= −3680 to −939) and third (mean difference €−2298, 95%CI= −4092 to −1288) compared to the first dislocation. Conclusions Nonoperative treatment of shoulder instability has substantial societal costs. Level of Evidence III, economic analysis.

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Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06475-1 ◽

2021 ◽

Author(s):

Yoann Bohu ◽

◽

Pierre Abadie ◽

Floris van Rooij ◽

Luca Nover ◽

...

Keyword(s):

Shoulder Instability ◽

Multivariable Analysis ◽

Return To Sport ◽

Patient Characteristics ◽

Return To Play ◽

Anterior Shoulder Instability ◽

Latarjet Procedure ◽

Level Of Evidence ◽

Injury Index ◽

Sport Type

Abstract Purpose Systematic reviews report return to play (RTP) within 5.8 months (range, 3–8) following the Latarjet procedure, but the factors that influence RTP remain unknown. The present study aimed to report the rate and time of return to play (RTP) during the first 8 months following the Latarjet procedure, and to determine the influence of sport type or patient characteristics. Methods The authors retrospectively collected the records of patients that underwent Latarjet procedures for anterior shoulder instability between 2015 and 2017. Patients were excluded if they had any concomitant rotator cuff tendon lesions, or previous ipsilateral shoulder surgery. The authors retrieved patient demographics, time from injury to surgery, type of sport practiced (overhead/non-overhead, contact/non-contact), as well as pre- and postoperative Western Ontario Shoulder Instability index (WOSI), Shoulder Instability-Return to Sport After Injury index (SIRSI), and Rowe score. Results A total of 217 patients (217 shoulders) were eligible for inclusion, comprising 184 males and 33 females, aged 26.8 ± 7.3 years at index surgery. The main sport practiced prior to surgery involved overhead (n = 173, 80%) and/or contact (n = 152, 70%) activities. By 8 month follow-up, 158 patients (73%) resumed their main sport, at a mean of 5.1 ± 1.5 months. Multivariable analysis revealed that RTP was more likely in patients with higher preoperative Rowe score (OR, 1.02; p = 0.024) and SIRSI score (OR, 1.02; p = 0.008). Conclusions By 8 months following the Latarjet procedure, 73% of patients had resumed their main sport. The likelihood of RTP was significantly associated with preoperative Rowe and SIRSI scores, but not with sport type. Level of evidence IV.

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