Division 1 Collegiate American Football Players Experience a Low Revision Rate After Undergoing Arthroscopic Shoulder Labral Repair

Purpose: To describe rates of revision surgery and recurrence events, as well as to evaluate functional outcomes and return to play (RTP) of a cohort of Division 1 (D1) collegiate American football players who underwent arthroscopic labral repair for shoulder instability. Methods: D1 collegiate American football players undergoing arthroscopic surgical management of shoulder instability between 2017 and 2021 at a single institution were included. Demographics, imaging, surgical details, and postoperative outcomes, including revision surgery and Western Ontario Shoulder Instability Index (WOSI), were collected. Hill-Sachs lesions and glenoid bone loss were evaluated on magnetic resonance imaging. Results: Fifteen shoulders of 15 consecutive male athletes were included, with mean age of 19.7 ± 1.0 years and mean follow-up of 2.1 ± 1.0 years. Twelve injuries were shoulder subluxations and 3 were dislocations. Seven cases were posterior injuries, 4 were anterior, and 4 included both anterior and posterior injuries. All patients underwent arthroscopic labrum repair alone, without remplissage or any additional open procedures. A mean of 6 anchors were used in each shoulder, with anchors being placed in at least 2 quadrants. Hill-Sachs lesions were observed in 6 shoulders (40%). Thirteen shoulders had no glenoid bone loss, and 2 had >15% glenoid bone loss. Two shoulders required revision surgery. Significant differences were found in postoperative WOSI scores between patients with and without recurrent instability (66.9 ± 11.5% vs 94.6 ± 5.0%), and between patients with and without Hill-Sachs lesions (84.6 ± 14.7% vs 95.0 ± 5.9%). Fourteen patients (93%) RTP at the same level. Conclusions: Arthroscopic labral repairs as a treatment for shoulder instability in D1 American football players, without remplissage/bone block procedures, yielded low recurrence and revision rates, and a high RTP rate. Additionally, Hill-Sachs lesions and recurrent shoulder instability were associated with inferior postoperative subjective outcomes (WOSI score). Level of Evidence: Level IV, therapeutic case series.