In this episode, we’re going to continue our discussion with Dr. Yoni Rosenblatt and focus on the rehab of different stabilization surgeries, including arthroscopic Bankart repair, Bankart with the addition of a remplissage procedure, and Latarjet reconstruction. We then wrap up with a discussion on return to play and an important conversation on the psychological aspects of recovery.
Our conversation picks back up with an article from the March 2020 issue of Sports Health titled “A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair.” Dr. Nik Verma and team at Rush reviewed 31 PT protocols and found a high degree of variability with regard to exercises and motion goal recommendations. Despite the variability, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols, which may contribute to the earlier return to play metrics identified in the literature for Latarjet compared to Bankart repair.
Next, we review an article titled “Functional Rehabilitation and Return to Play After Arthroscopic Surgical Stabilization for Anterior Shoulder Instability” published in the December 2021 issue of Sports Health. In this case series, Dr. Brian Busconi and colleagues at UMass evaluated 62 athletes who underwent arthroscopic Bankart repair and were subsequently cleared to return to sports using both functional and psychological testing. The average time to pass psychological testing was 5 months, while the average time to pass functional testing was 6 months. The re-dislocation rate of 2 years was 6.5%, lower than what is currently published for this population.
We finish up today with an article from the October issue of AJSM titled “Relationship of the SIRSI Score to Return to Sports After Surgical Stabilization of Glenohumeral Instability.” Dr. Rossi and colleagues in Argentina reported that patients who returned to sports and those who returned to their preinjury sports level were significantly more psychologically ready than those who did not return. In fact, for every 10-point increase in the SIRSI score, the odds of returning to sports increased by 2.9 times. Furthermore, those who did not achieve their preinjury sports level showed poorer psychological readiness to return to play and SIRSI score results.