Effect of Playing Position on Return to Sport, Functional Outcomes, and Recurrence After Arthroscopic Bankart Repair in Soccer Players

Abstract

Background: Little attention has been paid to playing position as a risk factor for recurrence after arthroscopic Bankart repair (ABR) in soccer players. Purpose: To compare return to sport, functional outcomes, and recurrence after ABR between goalkeepers and field position players in soccer. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective comparative cohort study was performed in soccer players who underwent ABR between January 2017 and December 2019. The minimum clinical follow-up was 2 years. Functional outcomes included the Rowe score, visual analog scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). The difference between the post- and preoperative scores was calculated; rate and level of return to sport, recurrent instability, and revisions were also evaluated according to position played. Results: A total of 70 position players and 11 goalkeepers met the study criteria. Postoperative functional outcomes were significantly improved in both groups as compared with baseline ( P < .001 for both), although the position players achieved significantly greater pre- to postoperative improvement (ΔVAS, –2 vs 0 points [ P = .029]; ΔRowe, 45 vs 30 points [ P = .046]; ΔASOSS, 45 vs 40 points [ P = .028]). While all players returned to soccer, only 55% (n = 6) of goalkeepers returned to the same level versus 93% of field players ( P = .003). The overall rate of recurrent instability was 8.6% but was significantly higher among goalkeepers (27.2% vs 5.7%; P = .049), and the odds of goalkeepers having a recurrence were significantly higher than field position players (odds ratio, 8.5 [95% CI, 1.2-57.2]; P = .027). Conclusion: Although the results of ABR were generally favorable in all soccer players, goalkeepers had significantly worse functional outcomes, a lower rate of return to the same level of sport, and a higher recurrence rate as compared with field position players.