Shoulder Surgery Studies in Contact and Collision Athletes Prioritize Patient-Reported Outcomes but Infrequently Report Athlete-Specific Measures: A Systematic Review.

Abstract

To systematically evaluate outcome reporting practices in studies of shoulder surgery in competitive contact and collision sport athletes and determine whether athlete-relevant outcome measures are being used. A systematic search based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in January 2025 using the Embase, MEDLINE, and Cochrane Library databases. Manuscripts were included if they studied competitive collision or contact athletes who underwent shoulder surgery, reported return to play (RTP) rates, and were published in a peer-reviewed journal in English. Extracted data included methodological quality, risk of bias, patient demographics, reported outcomes, and RTP reporting. A total of 65 studies including 3596 patients met inclusion criteria. Patient-reported outcome measures were reported in 48 studies (73.8%), with 13 (20.0%) including an athlete-specific patient-reported outcome measure. The most common patient-reported outcome measure was the Rowe score (n = 28). A minority of studies reported range of motion (n = 23; 35.4%), pain (n = 19; 29.2%), satisfaction (n = 14; 21.5%), and strength (n = 5; 7.7%). Objective sport outcomes were reported in 10 studies (15.4%). Thirty studies fully reported RTP with time to return and level of resumed play. Outcome reporting patterns were statistically comparable between collision and contact athlete studies. Outcome reporting in shoulder surgery for collision and contact athletes most commonly includes patient-reported outcomes but limited use of athlete-specific measures, basic clinical outcomes, and clinical thresholds. Many studies also omit RTP details, including time to return, level of play resumed, and criteria used for clearance. Level IV, systematic review of Level II to IV studies.