Rehabilitation after arthroscopic Bankart repair: a systematic scoping review identifying important evidence gaps

Willem McIsaac; Amaan Lalani; Anelise Silveira; Judy Chepeha; Charlene Luciak-Corea; Lauren Beaupre

doi:10.1016/j.physio.2021.03.014

Rehabilitation after arthroscopic Bankart repair: a systematic scoping review identifying important evidence gaps

Physiotherapy. 2022 Mar:114:68-76. doi: 10.1016/j.physio.2021.03.014. Epub 2021 Mar 24.

Authors

Willem McIsaac¹, Amaan Lalani², Anelise Silveira³, Judy Chepeha⁴, Charlene Luciak-Corea⁵, Lauren Beaupre⁶

Affiliations

¹ Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Canada.
² Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton Alberta, Canada T6G 2B4.
³ Department of Surgery, Alberta Health Services, 6-110 Clinical Sciences Building, 8224-112St, Edmonton, AB, Canada T6G 2G3; Shoulder and Upper Extremity Research Group of Edmonton, 6-110 Clinical Sciences Building, 8224-112St, Edmonton, AB, Canada T6G 2G3.
⁴ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton Alberta, Canada T6G 2B4; Shoulder and Upper Extremity Research Group of Edmonton, 6-110 Clinical Sciences Building, 8224-112St, Edmonton, AB, Canada T6G 2G3.
⁵ Shoulder and Upper Extremity Research Group of Edmonton, 6-110 Clinical Sciences Building, 8224-112St, Edmonton, AB, Canada T6G 2G3.
⁶ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton Alberta, Canada T6G 2B4; Shoulder and Upper Extremity Research Group of Edmonton, 6-110 Clinical Sciences Building, 8224-112St, Edmonton, AB, Canada T6G 2G3. Electronic address: lauren.beaupre@ualberta.ca.

PMID: 34598773
DOI: 10.1016/j.physio.2021.03.014

Abstract

Background: Evidence to develop best rehabilitation practices after Arthroscopic Bankart Repair (ABR) is lacking, leading to heterogeneity in rehabilitation approaches.

Objectives: This systematic scoping review investigated current evidence for rehabilitation and associated outcomes following ABR, including rehabilitation parameters, evaluative approaches (outcomes/outcome measures, follow-up timing/duration).

Data sources: A systematic search was performed of CINAHL, MEDLINE, and Embase databases in May 2019.

Study selection: Prospective studies detailing rehabilitation protocols following ABR reporting at least one postoperative assessment within 1 year of surgery (to measure impact of rehabilitation) were included.

Data extraction and synthesis: Two blinded reviewers independently selected studies using standardized criteria and extracted study characteristics and outcomes of interest. Quality of evidence was assessed using Joanna Brigg's quality assessment tool. A narrative analysis was conducted and evidence gaps were identified.

Results: Nine studies evaluating 11 rehabilitation protocols with a total of 384 participants were included. Considerable variability was seen in rehabilitation protocols and evaluation parameters. Return to sports/activity was frequently measured, but not well-defined. Strengthening was an important component of rehabilitation protocols, but rarely reported as an outcome. Follow-up was variable, with 4 studies ending follow-up before 24-months postoperatively. Overall, patient outcomes improved postoperatively.

Conclusions: There is a paucity of evidence investigating the impact of rehabilitation approaches following ABR. Although patient outcomes improve after ABR, selected outcomes/measures are highly variable with limited evidence on those important to measure rehabilitation success, particularly strength and return to activity. Identified evidence gaps should be addressed in future research.

Keywords: Arthroscopic Bankart repair; Postoperative rehabilitation; Return to sport.

Publication types

Review
Systematic Review

MeSH terms

Arthroscopy* / methods
Arthroscopy* / rehabilitation
Humans
Prospective Studies