scholarly journals Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098205
Author(s):  
Brian C. Lau ◽  
Lorena Bejarano Pineda ◽  
Tyler R. Johnston ◽  
Bonnie P. Gregory ◽  
Mark Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Return To Play ◽  
Rate Of Return ◽  
Bone Block ◽  
Complication Rates ◽  
Weighted Mean ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Patient Goals ◽  
Open Stabilization

Background: Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients. Purpose: To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures. Study Design: Systematic review; Level of evidence, 4. Methods: All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score. Results: Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72). Conclusion: Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization.

scholarly journals Return to Sport After Proximal Hamstring Tendon Repair: A Systematic Review

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985321 ◽  
Author(s):  
John W. Belk ◽  
Matthew J. Kraeutler ◽  
Omer Mei-Dan ◽  
Darby A. Houck ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Intervention ◽  
Return To Sport ◽  
Hamstring Tendon ◽  
Activity Level ◽  
Return To Play ◽  
Rate Of Return ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Proximal Hamstring

Background: Previous studies have evaluated functional outcomes and return-to-sport rates after proximal hamstring tendon (HT) repair. Purpose: To systematically review the literature in an effort to evaluate return-to-sport rates after proximal HT repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies that evaluated postoperative lower extremity function and return-to-sport rates in patients after proximal HT repair. Search terms used were “hamstring,” “repair,” “return to sport,” and “return to play.” Patients were assessed based on return to sport, return to preinjury activity level, type of HT tear (complete or partial), and interval from injury to surgery. Patients were also divided into subgroups depending on timing of the surgical intervention: early, <1 month; delayed, 1 to 6 months; and late, >6 months from the time of injury. Results: Sixteen studies (one level 2, five level 3, ten level 4) met the inclusion criteria, including 374 patients with a complete proximal HT tear (CT group) and 93 patients with a partial proximal HT tear (PT group), with a mean follow-up of 2.9 years. Overall, 93.8% of patients (438/467) returned to sport, including 93.0% (348/374) in the CT group and 96.8% (90/93) in the PT group ( P = .18). The mean time to return to sport was 5.7 months, and 83.5% of patients (330/395) returned to their preinjury activity level. The early group demonstrated the greatest rate of return to sport at 94.4% (186/197) as well as the quickest time to return at a mean of 4.8 months, although this was not found to be statistically significant. Conclusion: Over 90% of patients undergoing repair of a complete or partial proximal HT tear can be expected to return to sport regardless of the tear type. Early surgical interventions of these injuries may be associated with a quicker return to sport, although the rate of return to sport does not differ based on timing of the surgical intervention.

It’s Not All About Redislocation: A Systematic Review of Complications After Anterior Shoulder Stabilization Surgery

2018 ◽  
Vol 47 (13) ◽  
pp. 3277-3283 ◽  
Author(s):  
Huw Lloyd Morgan Williams ◽  
Jonathan Peter Evans ◽  
Nicholas Duncan Furness ◽  
Christopher David Smith
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Complication Rate ◽  
Tissue Repair ◽  
Labral Repair ◽  
Bone Block ◽  
Complication Rates ◽  
Shoulder Stabilization ◽  
Soft Tissue Repair ◽  
Bone Block Procedure

Background: The surgical treatment of recurrent shoulder instability has evolved in recent years to include a variety of soft tissue and bone block procedures, undertaken with either an open or arthroscopic approach. Although the utilization of such techniques has rapidly expanded, the associated risk of complications remains poorly defined. This information is vital for clinical decision making and patient counseling. Purpose: To quantify the complication rate associated with all types of surgery for anterior glenohumeral joint dislocation. Study Design: Systematic review. Methods: A systematic search was undertaken of studies reporting complications from anterior shoulder stabilization surgery. Inclusion criteria were studies published in English between 2000 and 2017 with a minimum 2-year follow-up. Methodological quality of the included studies was assessed with the Methodological Index for Non-Randomized Studies criteria. Complication rates for all undesirable events contributing to the patient outcome were extracted and cumulative rates calculated. Results: Out of 1942 references, 56 studies were included, totaling 4362 procedures among 4336 patients. Arthroscopic soft tissue repair had a complication rate of 1.6% (n = 2805). When repair was combined with arthroscopic remplissage, the rate was 0.5% (n = 219). Open soft tissue repair had a complication rate of 6.2% (n = 219) and open labral repair with remplissage, a rate of 2.3% (n = 79). An open bone block procedure had a complication rate of 7.2% (n = 573) and an arthroscopic bone block procedure, a rate of 13.6% (n = 163). Conclusion: This large systematic review demonstrates the overall complication rates (not purely recurrence rates) in modern shoulder stabilization surgery. With the growing interest in bone block stabilization procedures, including those performed arthroscopically, surgeons should be aware of the 10-fold increase in complications for these procedures over soft tissue arthroscopic surgery and counsel their patients accordingly.

scholarly journals Systematic Review of Orthopaedic and Sports Medicine Injuries and Treatment Outcomes in Women's National Basketball Association and National Basketball Association Players

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098207
Author(s):  
Sachin Allahabadi ◽  
Favian Su ◽  
Drew A. Lansdown
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Achilles Tendon ◽  
Sports Medicine ◽  
Direct Consequence ◽  
National Basketball Association ◽  
Return To Play ◽  
Level Of Evidence ◽  
Cartilage Injuries ◽  
Women's National Basketball Association

Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.

scholarly journals Failed Latarjet procedure: a systematic review of surgery revision options

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Matteo Buda ◽  
Riccardo D’Ambrosi ◽  
Enrico Bellato ◽  
Davide Blonna ◽  
Alessandro Cappellari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Latarjet Procedure ◽  
Shoulder Stabilization ◽  
Recurrent Instability ◽  
Level Of Evidence ◽  
Radiographic Outcomes

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/

Criteria for Return to Play After Hip Arthroscopy in the Treatment of Femoroacetabular Impingement: A Systematic Review

2021 ◽  
pp. 036354652110389
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Matthew G. Davey ◽  
Jordan W. Fried ◽  
Andrew J. Hughes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Operative Management ◽  
Return To Play ◽  
Return To Sports ◽  
Level Of Evidence ◽  
The Mean

Background: Femoroacetabular impingement (FAI) is a common pathology in athletes that often requires operative management in the form of hip arthroscopy. Purpose: To systematically review the rates and level of return to play (RTP) and the criteria used for RTP after hip arthroscopy for FAI in athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature, based on the PRISMA guidelines, was performed using PubMed, Embase, and Scopus databases. Studies reporting outcomes after the use of hip arthroscopy for FAI were included. Outcomes analyzed were RTP rate, RTP level, and criteria used for RTP. Statistical analysis was performed using SPSS software. Results: Our review found 130 studies, which included 14,069 patients (14,517 hips) and had a mean methodological quality of evidence (MQOE) of 40.4 (range, 5-67). The majority of patients were female (53.7%), the mean patient age was 30.4 years (range, 15-47 years), and the mean follow-up was 29.7 months (range, 6-75 months). A total of 81 studies reported RTP rates, with an overall RTP rate of 85.4% over a mean period of 6.6 months. Additionally, 49 studies reported the rate of RTP at preinjury level as 72.6%. Specific RTP criteria were reported in 97 studies (77.2%), with time being the most commonly reported item, which was reported in 80 studies (69.2%). A total of 45 studies (57.9%) advised RTP at 3 to 6 months after hip arthroscopy. Conclusion: The overall rate of reported RTP was high after hip arthroscopy for FAI. However, more than one-fourth of athletes who returned to sports did not return at their preinjury level. Development of validated rehabilitation criteria for safe return to sports after hip arthroscopy for FAI could potentially improve clinical outcomes while also increasing rates of RTP at preinjury levels.

Hip Dislocation and Subluxation in Athletes: A Systematic Review

2021 ◽  
pp. 036354652110361
Author(s):  
Deepak V. Chona ◽  
Paul D. Minetos ◽  
Christopher M. LaPrade ◽  
Mark E. Cinque ◽  
Geoffrey D. Abrams ◽  
...  
Keyword(s):  
Systematic Review ◽  
Arthroscopic Surgery ◽  
Treatment Strategies ◽  
Hip Dislocation ◽  
Return To Play ◽  
Exclusion Criteria ◽  
Level Of Evidence ◽  
Radiographic Outcomes ◽  
Center Edge

Background: Hip dislocation is a rare occurrence during sports but carries serious implications for athletes. Purpose: To systematically review treatment strategies and outcomes for hip dislocation in athletes, with the ultimate goal of providing sports medicine physicians with the information necessary to appropriately treat and counsel patients sustaining this injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, MEDLINE, and Embase were searched for studies relating to hip instability and athletics from January 1, 1989 to October 1, 2019. Abstracts and articles were evaluated on the basis of predefined inclusion and exclusion criteria. Inclusion criteria were the following: (1) data from ≥1 patients, (2) native hip dislocation or subluxation occurring during sports, (3) patients aged at least 10 years, and (4) written in English. Exclusion criteria were (1) patients younger than 10 years; (2) nonnative or postoperative hip dislocation or subluxation; (3) a native hip injury without dislocation or subluxation; (4) patients with dislocation or subluxation secondary to neuromuscular, developmental, or syndromic causes; (5) dislocation or subluxation not occurring during sports; (6) patients with physeal fractures; or (7) review articles or meta-analyses. Data were recorded on patient demographics, injury mechanism, treatment strategies, and clinical and radiographic outcomes. Where possible, pooled analysis was performed. Studies were grouped based on reported outcomes. Meta-analysis was then performed on these pooled subsets. Results: A total of 602 articles were initially identified, and after screening by 2 reviewers, 27 articles reporting on 145 patients were included in the final review. There were 2 studies that identified morphological differences between patients with posterior dislocation and controls, including decreased acetabular anteversion ( P = .015 and .068, respectively), increased prevalence of a cam deformity ( P < .0035), higher alpha angles ( P≤ .0213), and decreased posterior acetabular coverage ( P < .001). No differences were identified for the lateral center edge angle or Tonnis angle. Protected postreduction weightbearing was most commonly prescribed for 2 to 6 weeks, with 65% of reporting authors recommending touchdown, toe-touch, or crutch-assisted weightbearing. Recurrence was reported in 3% of cases. Overall, 4 studies reported on findings at hip arthroscopic surgery, including a 100% incidence of labral tears (n = 27; 4 studies), 92% incidence of chondral injuries, 20% incidence of capsular tears, and 84% incidence of ligamentum teres tears (n = 25; 2 studies). At final follow-up, 86% of patients reported no pain (n = 14; 12 studies), 87% reported a successful return to play (n = 39; 10 studies), and 11% had radiographic evidence of osteonecrosis (n = 38; 10 studies). Conclusion: Various treatment strategies have been described in the literature, and multiple methods have yielded promising clinical and radiographic outcomes in patients with native hip dislocation sustained during sporting activity. Data support nonoperative treatment with protected weightbearing for hips with concentric reduction and without significant fractures and an operative intervention to obtain concentric reduction if unachievable by closed means alone. Imaging for osteonecrosis is recommended, with evidence suggesting 4- to 6-week magnetic resonance imaging and follow-up at 3 months for those with suspicious findings in the femoral head.

scholarly journals Return to Sport After Ankle Syndesmotic Injury: A Systematic Review

2018 ◽  
Vol 11 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Seline Y. Vancolen ◽  
Ibrahim Nadeem ◽  
Nolan S. Horner ◽  
Herman Johal ◽  
Bashar Alolabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Return To Sport ◽  
Nonoperative Treatment ◽  
High Rate ◽  
Rate Of Return ◽  
Syndesmotic Injury ◽  
Level Of Evidence ◽  
Treatment Groups ◽  
Pertinent Data

Context: Ankle syndesmotic injuries present a significant challenge for athletes due to prolonged disability and recovery periods. The optimal management of these injuries and rates of return to sport in athletes remains unclear. Objective: The purpose of this study was to evaluate return to sport for athletes after ankle syndesmotic injuries. Data Source: The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from database inception to January 15, 2017, and pertinent data were abstracted. Study Selection: Only studies reporting return-to-sport rates after ankle syndesmotic injuries were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two reviewers extracted data from the included studies, which were stored in a standardized collection form (Microsoft Excel). Recorded data included demographics (eg, author, year of publication, study design), descriptive statistics (eg, patient age, percentage male, number of athletes, sample size), and outcomes (eg, time to return to sport, proportion of those who returned to sport, the self-reported questionnaire the Olerud-Molander Ankle Score). Results: A total of 10 studies and 312 patients with ankle syndesmotic injuries were included in this systematic review. The rate of return to preinjury or any injury level of sport after ankle syndesmotic injuries was 93.8% ± 1.2% and 97.6% ± 1.5%, respectively, for the corresponding 7 and 3 studies that reported this characteristic. The mean time to return to sport was 46.4 days (range, 15.4-70 days), with 55.2 ± 15.8 and 41.7 ± 9.8 days for operative and nonoperative management, respectively. Conclusion: This systematic review found a high rate of return to any as well as preinjury level of sport after ankle syndesmotic injury in both operative and nonoperative treatment groups. However, further high-level studies are required to compare operative and nonoperative treatment groups associated with return to sport after ankle syndesmotic injury.

scholarly journals Outcomes and Complications After Primary Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis for Superior Labral Anterior-Posterior Tears or Biceps Abnormalities: A Systematic Review and Meta-analysis

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094532
Author(s):  
Zi Jun Deng ◽  
Clark Yin ◽  
Joseph Cusano ◽  
Hussein Abdul-Rassoul ◽  
Emily J. Curry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Constant Score ◽  
Meta Analysis ◽  
Complication Rates ◽  
Biceps Tenodesis ◽  
Weighted Mean ◽  
Meta Analyses ◽  
Subpectoral Biceps Tenodesis ◽  
Popeye Deformity ◽  
Anterior Posterior

Background: Biceps tenodesis is a surgical treatment for both superior labral anterior-posterior (SLAP) tears and long head of the biceps tendon (LHBT) abnormalities. Biceps tenodesis can be performed either above or below the pectoralis major tendon with arthroscopic or open techniques. Purpose: To analyze the outcomes and complications comparing primary arthroscopic suprapectoral versus open subpectoral biceps tenodesis for either SLAP tears or LHBT disorders. Study Design: Systematic review; Level of evidence, 4. Methods: A search strategy based on the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) protocol was used to include 18 articles (471 patients) from a total of 974 articles identified. Overall exclusion criteria included the following: non–English language, non–full text, biceps tenodesis with concomitant rotator cuff repair, review articles, meta-analyses, and case reports. Data were extracted and analyzed according to procedure type and tenodesis location: arthroscopic suprapectoral biceps tenodesis (295 patients) versus open subpectoral bicepts tenodesis (176 patients). Results: For arthroscopic suprapectoral biceps tenodesis, the weighted mean American Shoulder and Elbow Surgeons (ASES) score was 90.0 (97 patients) and the weighted mean Constant score was 88.7 (108 patients); for open subpectoral biceps tenodesis, the mean ASES score was 91.1 (199 patients) and mean Constant score was 84.7 (65 patients). Among the 176 patients who underwent arthroscopic biceps tenodesis, there was an overall complication rate of 9.1%. Among the 295 patients who underwent open biceps tenodesis, there was an overall complication rate of 13.5%. Both residual pain (5.7% vs 4.7%, respectively) and Popeye deformity (1.7% vs 1.0%, respectively) rates were similar between the groups. Open subpectoral biceps tenodesis had higher reoperation (3.0% vs 0.0%, respectively), wound complication (1.0% vs 0.0%, respectively), and nerve injury (0.7% vs 0.0%, respectively) rates postoperatively. A meta-analysis of 3 studies demonstrated that both methods had similar ASES scores ( P = .36) as well as all-cause complication rates (odds ratio, 0.76 [95% CI, 0.13-4.48]; P = .26). Conclusion: Patients undergoing arthroscopic suprapectoral biceps tenodesis for either SLAP tears or LHBT abnormalities had similar outcome scores and complication rates compared with those undergoing open subpectoral biceps tenodesis. Additionally, both residual pain and Popeye deformity rates were similar between the 2 groups.

scholarly journals Return to Play After Isolated Meniscal Repairs in Athletes: A Systematic Review

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096209
Author(s):  
Erica R. Blanchard ◽  
Christopher J. Hadley ◽  
Eric D. Wicks ◽  
William Emper ◽  
Steven B. Cohen
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Return To Play ◽  
Meniscal Tears ◽  
Arthroscopic Technique ◽  
Level Of Evidence ◽  
Study Results ◽  
Anterior Cruciate

Background: Meniscal tears are a common knee injury. Isolated meniscal tears are less common; however, unaddressed tears can be troublesome, particularly for athletes. There is currently a lack of data in the literature on athletes returning to play after isolated meniscal repair. Purpose: To evaluate the return to play rate and time to return to play for athletes with isolated meniscal injuries. Study Design: Systematic review; Level of evidence, 4. Methods: A search of the PubMed, EMBASE, and Cochrane electronic databases was conducted to identify studies that reported the time and the rate of return to play in athletes after repair of isolated meniscal tears. Studies were excluded if there was a concomitant anterior cruciate ligament reconstruction, if there was a meniscectomy instead of a meniscal repair, or if the study was a systematic review. Quality assessment and data extraction were performed by 2 examiners. Results: Overall, 21 studies were included in this review. There were 355 athletes (358 knees) with a mean age of 22.5 years (range, 9-68 years). A sex breakdown was noted in 16 of the 21 (76.2%) studies with 224 men and 71 women. The specific repair technique was described in 259 (72.3%) knees. Of the total knees, 109 (30.4%) had an open repair, 128 (35.8%) had an inside-out arthroscopic technique repair, and 22 (6.1%) had an all-inside arthroscopic technique repair. Complications were addressed in 11 studies, with 13 out of 155 (8.4%) patients across the 11 articles having a postoperative complication. Of the total 355 patients, 295 (83.1%) returned to play, and 17 of these 21 (81.0%) articles reported the time it took for athletes to return to play, with a mean return of 8.7 months. Conclusion: The study results indicate that return to play rates after isolated meniscal repair are high, with an overall return to play rate of 83.1% and a mean return to play time of 8.7 months. However, the limited number of studies, particularly ones with larger patient numbers, highlights the need for further investigation regarding isolated meniscal repair in athletes.

scholarly journals Diagnosis and Management of Little League Shoulder: A Systematic Review

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110175
Author(s):  
E. Dimitra Bednar ◽  
Jeffrey Kay ◽  
Muzammil Memon ◽  
Nicole Simunovic ◽  
Laura Purcell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
English Language ◽  
Sport Participation ◽  
Return To Play ◽  
Adolescent Male ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Little League ◽  
Little League Shoulder

Background: Little League shoulder (LLS) is an overuse injury characterized by throwing-related pain that commonly presents in adolescent male athletes. Investigations into the optimal duration of rest from throwing and protocols for graduated return to sports (RTS) are lacking. Purpose: To summarize the current literature with respect to the diagnosis, management, RTS, and return to throwing for LLS. Design: Systematic review; Level of evidence, 4. Methods: The databases EMBASE, MEDLINE, and PubMed were searched between inception and April 22, 2020. References of retrieved records were reviewed for potentially eligible studies. English-language studies that reported the diagnosis and/or management of LLS in children or adolescents were included. Studies of animals or cadavers, review articles, and non—peer reviewed records were excluded. Data were summarized narratively using descriptive statistics. Results: Overall, 23 studies (21 level 4 studies, 2 level 3 studies) met the criteria for a total of 266 participants with a weighted mean age of 12.8 years (range, 7.4-17 years). Treatment recommendations evolved from prolonged rest and complete cessation of throwing to shorter periods of rest and graduated RTS. Less than half (11/23) of studies reported specific criteria to RTS; 1 case report discussed a coaching strategy to resume throwing, and 1 case report discussed a regimented throwing program. The proportion of participants returning to any sport participation was 94.0% (n = 157/167). The proportion returning to their preinjury level of sport was 92.5% (n = 123/133). Upon RTS, 18.7% (n = 35/187) of participants experienced a recurrence of symptoms. Premature closure of the epiphysis was reported in 1 participant. Conclusion: Young athletes with LLS may return to play after a period of rest, and a high proportion return to their preinjury level of sport. Further prospective studies are warranted to develop evidence-based, graduated RTS protocols and to better capture any long-term sequelae of the condition.

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