Moderate Return to Play and Prior Performance after Superior Labral Anterior-Posterior Repairs in Competitive Overhead Athletes: A Systematic Review

Abstract

Purpose

The purpose of this study was to perform a systematic review of return to play (RTP) and return to previous level of performance (RPP) in competitive overhead athletes after SLAP repair to identify factors associated with failure to RTP.

Methods

Systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Review was registered with PROSPERO International prospective register of systematic reviews (CRD42020215488). Inclusion criteria were literature reporting RTP or RPP following SLAP repair in overhead athletes were run in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Categories for data collection for each full article included (1)article information; (2)patient demographics; (3)surgical techniques; (4)level of competition; (5)rotator cuff treatment; (6)player position; (7)patient reported outcome measures (PROMs); (8)RTP and RPP rates. The Methodological Index for Non-randomized Studies (MINORS) checklist was used to evaluate quality of all included studies.

Results

Eight studies with 333 subjects were identified. Overall RTP and RPP rates were 50%-83.6% and 35.3%-64%, respectively. Patients with surgically treated rotator cuff pathology had lower RTP (12.5%-64.7%) rates compared to those without (80.0%-83.6%). Professional athletes had similar RTP rates (62.5%-81.5%) compared to high-school (75.0%-90.0%) and college athletes (12.5%-83.3%). However, professional athletes demonstrated the lowest relative range of reported RPP rates (27.7%-55.6%). Pitchers had lower RTP (62.5%-80.0%) and RPP (52.0%-58.9%) compared to position players (91.3% RTP, 76.3%-78.2% RPP).

Conclusion

Studies reviewed reported moderate RTP and RPP rates following SLAP repairs in competitive overhead athletes. Those with associated rotator cuff tear requiring treatment and baseball pitchers were less likely to RTP and RPP. Professional athletes had similar RTP to an amateur; however, they were less likely to RPP.