Arthroscopic shoulder stabilization in the young athlete: return to sport and revision stabilization rates

J Shoulder Elbow Surg. 2020 May;29(5):946-953. doi: 10.1016/j.jse.2019.09.033. Epub 2019 Dec 4.


Background: Shoulder instability in young athletes is a complex problem with higher recurrence, higher reoperation, and lower return to sport (RTS) rates after arthroscopic shoulder stabilization compared with adults.

Methods: This is a prospective case series of young athletes with anterior shoulder instability after arthroscopic stabilization surgery. Primary outcomes were RTS and revision surgery, minimum follow-up was 24 months. Exclusion criteria were more than 3 preoperative episodes of instability, significant bone loss, or primary posterior instability. Demographic data, recurrent instability, revision surgery, sports pre- and postsurgery, patient satisfaction, level of RTS, time to RTS, and Single Assessment Numeric Evaluation (SANE) scores were analyzed.

Results: Sixty-seven athletes met inclusion criteria, 19 females and 48 males, with a mean age of 17.5 years (range, 13-21 years). Fifty-nine (88%) athletes returned to sport at an average of 7.1 months (standard deviation, ±1.8); 50 (75%) returned to the same level or higher. Football and lacrosse were the most common sports. Four of 67 athletes (6%), all male, underwent revision stabilization at 11-36 months for recurrent instability. The overall mean SANE score was 88.

Conclusion: This study demonstrates that when the high-risk athlete, 21 years old or younger, is appropriately selected for arthroscopic shoulder stabilization by excluding those with 3 or more preoperative shoulder instability episodes and those with off-track and engaging instability patterns, excellent outcomes can be achieved with low revision surgery rates, high RTS rates, and high patient satisfaction.

Keywords: Anterior shoulder instability; Bankart repair; arthroscopic shoulder stabilization; return to sport; revision shoulder stabilization.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / surgery*
  • Male
  • Prospective Studies
  • Reoperation / statistics & numerical data*
  • Return to Sport*
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / surgery*
  • Young Adult