A High Percentage of Healthy Volunteers Fail to Pass Criteria-based Return to Sport Testing for Arthroscopic Bankart Repair.

Abstract

Purpose: To evaluate whether healthy volunteers can pass a previously published criteria-based return to sport (CBRTS) protocol after Bankart repair.

Methods: This was a prospective evaluation of asymptomatic volunteers conducted in March 2024. This study included 26 volunteers with no history of upper-extremity injury or surgery. Volunteers were assessed according to a published CBRTS protocol: (1) isometric testing of external rotation (ER) and internal rotation (IR) in the supine and prone position assessed by hand-held dynamometry; (2) isokinetic strength testing of ER and IR assessed by isokinetic dynamometry; (3) endurance testing of side lying ER, prone ER, and prone Y test; and (4) functional testing via closed kinetic chain upper extremity (CKCUE) stability test and unilateral shot put test. A limb symmetry index (LSI) and proportion of volunteers who passed each test were calculated. A passing LSI value was defined as LSI within 10% of the contralateral side, except for the shot put test, for which a passing value was defined as 80% ≤ LSI ≤ 110%. A passing score for the CKCUE stability test was ≥21.

Results: No individual participant passed all the tests; instead, an individual on average passed 47% of the CBRTS protocol. On average, the proportion of participants who passed isometric testing was 60.6% (range 46.2-69.2). For isokinetic testing, the proportion of participants passing was 41.4% (range 30.8-57.7). For endurance testing, the proportion of participants passing was 23.1% (range 19.2-30.8). Lastly, 50% of participants passed the CKCUE stability test, whereas 96.2% passed the unilateral shot put test. A nondominant arm deficit was apparent in 4 of the 12 bilateral arm tests.

Conclusions: This study shows that a high percentage of healthy individuals are unable to pass many of the post-Bankart repair CBRTS protocol tests. Specifically, no participant passed all the tests and individuals only passed 47% of the tests on average.

Level of evidence: Level III, prospective single-cohort study.