Study compares operative vs nonoperative treatment of shoulder instability in NFL players
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In National Football League athletes, nonoperative treatment of shoulder instability was linked with faster return to play, while operative treatment was associated with fewer cases of recurrent instability and longer career longevity.
Lafi S. Kahlil, MD, and colleagues analyzed the results of 91 NFL players who sustained a first-time glenohumeral instability injury from September 2000 to February 2019 and returned to play (RTP). Of the cohort, 58 players were managed operatively and 33 were managed nonoperatively. Researchers also noted quarterbacks were more likely to undergo immediate operative treatment compared with players at other positions.
Despite finding no significant differences in overall workload or performance after either management option, Kahlil and colleagues found the operative cohort played an average of 4.1 more seasons after treatment, while the nonoperative cohort played an average of 2.8 more seasons after treatment. The operative cohort also experienced fewer instances of recurrent instability (27%) compared with the nonoperative cohort (50%). However, researchers noted RTP rates were faster in the nonoperative cohort (5.43 weeks) compared with the operative cohort (36.62 weeks).
“Our investigation elucidates that operatively treated players have reduced recurrent instability injuries and nonoperatively treated players RTP quicker; however, neither treatment shows superiority in terms of player performance and game utilization,” Kahlil and colleagues wrote. “As such, treatment after a shoulder instability event should be individualized to the athlete’s injury characteristics, symptoms and personal or career preferences,” they added.
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