Purpose
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; and (8)
RTP and RPP rates. The Methodological Index for Non-randomized Studies 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%
to 83.6% and 35.3% to 64%, respectively. Patients with surgically treated rotator
cuff pathology had lower RTP (12.5%-64.7%) rates compared with those without (80.0%-83.6%).
Professional athletes had similar RTP rates (62.5%-81.5%) compared with 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 with position players (91.3% RTP,
76.3%-78.2% RPP).
Conclusions
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.
Level of Evidence
Level IV, systematic review of Level III-IV studies.
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Article info
Publication history
Published online: March 29, 2022
Accepted:
March 7,
2022
Received:
March 20,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: S.F.D. reports and board member/committee appointments for American Academy of Orthopaedic Surgeons. G.E.G. reports personal fees and other from Tornier, personal fees and other from DJO Global, other from Arthrex, other from Wright Medical Tech, other from DVS, other from Stryker, other from Zimmer, other from Breg, and other from DePuy Mitek, outside the submitted work; and medical/orthopaedic publications editorial/governing board of Journal of Shoulder and Elbow Surgery and board member/committee appointments for a Society of TASS. N.N.V. reports other from American Orthopaedic Society for Sports Medicine, other from American Shoulder and Elbow Surgeons, other from Arthrex, other from Arthroscopy, other from Arthroscopy Association of North America, other from Breg, other from Cymedica, other from Knee, other from Minivasive, other from Omeros, other from Orthospace, other from Ossur, other from SLACK Incorporated, other from Smith & Nephew, other from Vindico Medical-Orthopedics Hyperguide, and other from Wright Medical Technology, outside the submitted work. ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America
