Patient Outcomes and Return to Play After Arthroscopic Rotator Cuff Repair in Overhead Athletes: a Systematic Review

Overview

Journal J Orthop Traumatol

Specialties Emergency Medicine
Orthopedics

Date 2023 Jan 19

PMID 36656423

Authors

Filippo Migliorini

Giovanni Asparago

Francesco Cuozzo

Francesco Oliva

Frank Hildebrand

Nicola Maffulli

Affiliations

Soon will be listed here.

Abstract

Background: Rotator cuff tear injuries in overhead athletes are common and may lead to chronic pain and joint disability, impairing sport participation and leading to premature retirement. The improvement of the patient reported outcome measures (PROMs) was evaluated, as were the time and level of return to sport and the rate of complication in overhead athletes who had undergone arthroscopic rotator cuff repair.

Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In September 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar and Embase. No time constraints were used for the search. All the clinical trials investigating arthroscopic rotator cuff repair in overhead athletes were accessed.

Results: Data from 20 studies were collected. The mean length of the follow-up was 40 months. All PROMs improved at last follow-up: Kerlan-Jobe Orthopaedic Clinic score (P = 0.02), visual analogue scale (P = 0.003), Constant score (P < 0.0001), University of California Los Angeles Shoulder score (P = 0.006) and American Shoulder and Elbow Surgeons' score (P < 0.0001). Elevation also improved (P = 0.004). No difference was found in external and internal rotation (P = 0.2 and P = 0.3, respectively). In total, 75.4% (522 of 692 of patients) were able to return to play within a mean of 6.4 ± 6.0 months. Of 692 patients, 433 (62.5%) were able to return to sport at pre-injury level. Fourteen out of 138 patients (10.1%) underwent a further reoperation. The overall rate of complications was 7.1% (20 of 280).

Conclusion: Arthroscopic reconstruction of the rotator cuff is effective in improving function of the shoulder in overhead athletes, with a rate of return to sport in 75.4% of patients within an average of 6.4 months.

Level Of Evidence: III, systematic review.

Trial Registration: Not applicable.

Citing Articles

Full-thickness arthroscopic rotator cuff repair demonstrates low repair failure rates and high return to sport rates in patients aged 30 years and under at 9-year follow-up: A single-center case series.

Ifarraguerri A, Berk A, Gachigi K, Collins M, Dib A, Siparsky P Shoulder Elbow. 2025; 17585732241312192.

PMID: 39811680 PMC: 11726496. DOI: 10.1177/17585732241312192.

No Effect of Cigarette Smoking in the Outcome of Arthroscopic Management for Femoroacetabular Impingement: A Systematic Review.

Lucenti L, Maffulli N, Bardazzi T, Pipino G, Pappalardo G, Migliorini F J Clin Med. 2024; 13(23).

PMID: 39685673 PMC: 11642028. DOI: 10.3390/jcm13237214.

Return to Sports and Activities after Arthroscopic Treatments for Rotator Cuff Lesions in Young Patients Less Than 45-Years-Old: A Systematic Review.

Moussa M, Lang E, Gerometta A, Karam K, Chelli M, Grimaud O J Clin Med. 2024; 13(13).

PMID: 38999269 PMC: 11242758. DOI: 10.3390/jcm13133703.

Inhibition of CX3CL1 by treadmill training prevents osteoclast-induced fibrocartilage complex resorption during TBI healing.

Liu X, Zhou M, Tan J, Ma L, Tang H, He G Front Immunol. 2024; 14:1295163.

PMID: 38283363 PMC: 10811130. DOI: 10.3389/fimmu.2023.1295163.

Time of Return to Work (RTW) May Not Correlate with Patient-Reported Outcomes Measurements (PROM) at Minimum One Year Post Arthroscopic Bankart Repair.

Kosior M, Sibilska A, Piwnik M, Borowski A, Prusaczyk S, Rogers J J Clin Med. 2023; 12(18).

PMID: 37762735 PMC: 10532194. DOI: 10.3390/jcm12185794.

References

Ide J, Maeda S, Takagi K . Sports activity after arthroscopic superior labral repair using suture anchors in overhead-throwing athletes. Am J Sports Med. 2005; 33(4):507-14. DOI: 10.1177/0363546504269255. View

Hougs Kjaer B, Magnusson S, Warming S, Henriksen M, Krogsgaard M, Juul-Kristensen B . Progressive early passive and active exercise therapy after surgical rotator cuff repair - study protocol for a randomized controlled trial (the CUT-N-MOVE trial). Trials. 2018; 19(1):470. PMC: 6122575. DOI: 10.1186/s13063-018-2839-5. View

Azzam M, Dugas J, Andrews J, Goldstein S, Emblom B, Cain Jr E . Rotator Cuff Repair in Adolescent Athletes. Am J Sports Med. 2018; 46(5):1084-1090. DOI: 10.1177/0363546517752919. View

Altintas B, Anderson N, Dornan G, Boykin R, Logan C, Millett P . Return to Sport After Arthroscopic Rotator Cuff Repair: Is There a Difference Between the Recreational and the Competitive Athlete?. Am J Sports Med. 2019; 48(1):252-261. DOI: 10.1177/0363546519825624. View

Lin K, Wang D, Dines J . Injection Therapies for Rotator Cuff Disease. Orthop Clin North Am. 2018; 49(2):231-239. DOI: 10.1016/j.ocl.2017.11.010. View

Aydin N, Karaismailoglu B, Gurcan M, Ozsahin M . Arthroscopic double-row rotator cuff repair: a comprehensive review of the literature. SICOT J. 2018; 4:57. PMC: 6294008. DOI: 10.1051/sicotj/2018048. View

Maier D, Jaeger M, Ogon P, Bornebusch L, Izadpanah K, Suedkamp N . Suture anchors or transglenoidal sutures for arthroscopic repair of isolated SLAP-2 lesions? A matched-pair comparison of functional outcome and return to sports. Arch Orthop Trauma Surg. 2012; 133(2):227-35. DOI: 10.1007/s00402-012-1657-6. View

Placzek J, Lukens S, Badalanmenti S, Roubal P, Freeman D, Walleman K . Shoulder outcome measures: a comparison of 6 functional tests. Am J Sports Med. 2004; 32(5):1270-7. DOI: 10.1177/0363546503262193. View

Popp D, Schoffl V . Superior labral anterior posterior lesions of the shoulder: Current diagnostic and therapeutic standards. World J Orthop. 2015; 6(9):660-71. PMC: 4610908. DOI: 10.5312/wjo.v6.i9.660. View

10.

Franz J, McCulloch P, Kneip C, Noble P, Lintner D . The utility of the KJOC score in professional baseball in the United States. Am J Sports Med. 2013; 41(9):2167-73. DOI: 10.1177/0363546513495177. View

11.

Van Kleunen J, Tucker S, Field L, Savoie 3rd F . Return to high-level throwing after combination infraspinatus repair, SLAP repair, and release of glenohumeral internal rotation deficit. Am J Sports Med. 2012; 40(11):2536-41. DOI: 10.1177/0363546512459481. View

12.

Kim K, Shin H, Lee W, Han S . Repair integrity and functional outcome after arthroscopic rotator cuff repair: double-row versus suture-bridge technique. Am J Sports Med. 2011; 40(2):294-9. DOI: 10.1177/0363546511425657. View

13.

Friel N, Karas V, Slabaugh M, Cole B . Outcomes of type II superior labrum, anterior to posterior (SLAP) repair: prospective evaluation at a minimum two-year follow-up. J Shoulder Elbow Surg. 2010; 19(6):859-67. PMC: 3869567. DOI: 10.1016/j.jse.2010.03.004. View

14.

Coleman B, Khan K, Maffulli N, Cook J, Wark J . Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000; 10(1):2-11. DOI: 10.1034/j.1600-0838.2000.010001002.x. View

15.

Boileau P, Parratte S, Chuinard C, Roussanne Y, Shia D, Bicknell R . Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med. 2009; 37(5):929-36. DOI: 10.1177/0363546508330127. View

16.

Michener L, McClure P, Sennett B . American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg. 2002; 11(6):587-94. DOI: 10.1067/mse.2002.127096. View

17.

Abdul-Rassoul H, Defazio M, Curry E, Galvin J, Li X . Return to Sport After the Surgical Treatment of Superior Labrum Anterior to Posterior Tears: A Systematic Review. Orthop J Sports Med. 2019; 7(5):2325967119841892. PMC: 6506928. DOI: 10.1177/2325967119841892. View

18.

Narvani A, Imam M, Godeneche A, Calvo E, Corbett S, Wallace A . Degenerative rotator cuff tear, repair or not repair? A review of current evidence. Ann R Coll Surg Engl. 2020; 102(4):248-255. PMC: 7099167. DOI: 10.1308/rcsann.2019.0173. View

19.

Park J, Chung S, Jeon S, Lee J, Oh K . Clinical and radiological outcomes of type 2 superior labral anterior posterior repairs in elite overhead athletes. Am J Sports Med. 2013; 41(6):1372-9. DOI: 10.1177/0363546513485361. View

20.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View