Mount Nittany Physician Group Orthopedics surgeon presents on return to sport testing after arthroscopic shoulder stabilization

The AANA Annual Meeting is the world’s largest arthroscopy-focused event of the year, where orthopedic surgeons and medical professionals come together from across the globe to share over 100 top-rated and award-winning presentations to improve outcomes.

The 2020 AANA Annual Meeting was originally scheduled to be held in May in Grapevine, Texas. However, due to the COVID-19 pandemic, the members were unable to meet in person. The AANA provided the opportunity for the AANA members to connect virtually via a live webinar in June, where over 200 members attended.

Only eight of the best presentations were selected to present at the live webinar. Dr. Wilson, who has been involved in the AANA as a member of the Communications and Technology Committee and as a former 2016 AANA Traveling Fellow, was one of the eight selected to present his top-rated presentation.

The presentation highlights the study titled “Return to sport testing at six months after arthroscopic shoulder stabilization reveals residual strength and functional deficits,” conducted by Dr. Wilson and the research team led by Albert Lin, MD, UPMC Freddie Fu Sports Medicine Center. The study was recently published in the Journal of Shoulder and Elbow Surgery in July 2020.

Dislocations and instability are common shoulder injuries during sports. After surgery, patients undergo rehabilitation for four to six months before released to return to sports by their surgeon. Returning to sport after surgery is the ultimate challenge. Unfortunately, some patients suffer another dislocation after returning to sport following surgery, which is devastating to the patient and the surgeon. Most research has focused on surgical techniques, but this study focused on deciding when it is safe to return to sports after surgery. Traditionally, return to sports is based on time from surgery and exam in the clinic. Dr. Wilson and the team went a step further and tested each patient for strength and function using state of the art strength machines and functional tests.

“A good outcome after arthroscopic surgery for shoulder instability means returning to the same level of performance without further instability. There is currently no consensus regarding timing or objective criteria for return to sport,” says Dr. Wilson. “Our focus was to formally test our athletes to see if they are actually ready to return to athletics after surgery.”

“Forty-three subjects who underwent arthroscopic shoulder stabilization surgery from 2016 until 2018 were formally tested for strength and function after completing rehabilitation six months after surgery. All subjects were competitive athletes,” shares Dr. Wilson.

“Looking at the results, only five of the 43 subjects were able to successfully pass the series of tests for both strength and function. Functional goals were more often met than strength, which may show that our athletes are able to compensate for residual and hidden strength deficits,” states Dr. Wilson. “These patients may be at risk if we return them too soon. Also, there may be opportunities to improve the rehabilitation process and get them back faster and safer.”

“I think the study sheds some much needed light on the complicated decision on when an athlete is actually ready to go back to perform after shoulder surgery. Routine strength and functional testing could provide more reliable criteria than arbitrary passage of time for return to play after shoulder stabilization surgery. The team and I are continuing to study return to sport testing after shoulder surgery to improve the process and reduce recurrent instability,” shares Dr. Wilson.