Posterior capsulolabral reconstruction results in good clinical and return to sport outcomes in tennis players with microtraumatic posterior shoulder instability.

Abstract

Microtraumatic posterior shoulder instability (PSI) can affect tennis players due to the repetitive demands placed on the dominant shoulder during the preparation of backhands, backhand volleys, and the follow-through phase of forehands and serves. Treatment of microtraumatic PSI typically involves a trial of conservative management, and if this fails, surgical stabilization may be warranted. To date, the effect of shoulder stabilization surgery on PSI in tennis players has not been investigated. The objective of this paper is to retrospectively review return-to-sport success and patient-reported outcome measures (PROMs) in high-level tennis players who have undergone capsulolabral reconstruction for microtraumatic PSI. A retrospective review of professional or semiprofessional tennis players who had undergone posterior capsulolabral reconstruction (PCR) for microtraumatic PSI was performed. The PROMs included the Western Ontario Shoulder Index (WOSI), Melbourne Instability Shoulder Score (MISS), and Subjective Shoulder Value (SSV), evaluated preoperatively and a mean of 12 months and 6 years postoperatively. Return to sport (RTS) (time to return and level) and any adverse events associated with surgery were reported. Data analysis for the WOSI, MISS, and SSV focused on detecting within-group treatment effects at 12 months and 6 years using linear mixed models. Fourteen tennis players (2 females, 12 males, mean age: 20.0 years) with microtraumatic PSI were included in the study. Post-surgery, participants showed statistically significant improvements at 12 months and 6 years for the WOSI, the MISS, and the SSV (p ​< ​0.05). Return-to-sport data were available for 12 athletes. Eleven players (91.6%) were able to return to tennis competitively at a median time of 12 months (range: 5-72 months) postoperatively. Six of the 11 players (54.5%) who returned to competition were able to return to the same or a higher level than preoperatively. For the whole cohort (n ​= ​14) there were five minor adverse events, primarily related to post-operative inflammation and/or ongoing stiffness. No recurrence of instability was reported. PCR results in good clinical and return-to-sport outcomes in tennis players with microtraumatic PSI who have failed conservative management, though return to previous level of play is more variable. IV (Case Series).