Background:Isokinetic torque in shoulder internal rotation (IR) and external rotation (ER) can be considered as potential indicators for dynamic stability of the glenohumeral joint.Purpose:To assess the efficacy of 4-month isokinetic testing in predicting the 6-month return-to-sports (RTS) status after Latarjet surgery, explore its correlations with testing parameters, and identify optimal thresholds to ensure a safe RTS.Study Design:Cohort study; Level of evidence, 2.Methods:The study assessed athletes who underwent the Latarjet stabilization procedure between January 2022 and June 2023. The primary outcome was RTS at 6 months after surgery. The primary examined predictors were isokinetic testing metrics at 4 months postoperatively. Secondary outcomes comprised the modified Closed Kinetic Chain Upper Extremity Stability Test (mCKCUEST) and several patient-reported outcome measures, including the Walch-Duplay score, the Western Ontario Shoulder Instability Index (WOSI), and the Shoulder Instability–Return to Sports after Injury scale. To assess the predictors, patients were divided into those who returned to any level of sports compared with those who did not return to sports. The correlation between isokinetic testing results and other outcome scores was also analyzed.Results:A total of 71 patients (mean age, 27.43 ± 9.09 years) were included in the study. Of these, 23.61% did not return to sports, 38.89% returned at a lower level, and 37.50% returned to the same level. Significant rotational strength disparities were noted. Patients who did not return to sports at 6 months demonstrated inferior strength in concentric ER at 60 deg/s, concentric ER at 240 deg/s, concentric IR at 240 deg/s, and eccentric IR at 30 deg/s ( P < .05). Similar trends appeared for all studied patient-reported outcome measures and the mCKCUEST ( P < .05). Receiver operating characteristic analysis emphasized the significance of isokinetic testing in concentric ER at 240 deg/s (area under the curve = 0.759; P = .001; cutoff = 0.32 N·m/kg; sensitivity = 100.0%; specificity = 49.1%) and eccentric ER at 30 deg/s (area under the curve = 0.760; P = .001; cutoff = 0.51 N·m/kg; sensitivity = 94.1%; specificity = 49.1%) for RTS prediction. Additionally, ER strength moderately correlated with the Walch-Duplay score across all examined velocities ( r = 0.26-0.34; P < .05). The modified WOSI score was weakly linked to ER strength at 240 deg/s and 30 deg/s ( r = 0.24-0.25; P < .05) as well as moderately linked to the limb symmetry index in ER at 60 deg/s and 30 deg/s ( r = 0.30-0.38; P < .05).Conclusion:Isokinetic testing can act as an independent predictor of successful RTS after Latarjet surgery, with concentric ER at 240 deg/s, concentric IR at 240 deg/s, eccentric ER at 30 deg/s, and eccentric IR at 30 deg/s showing the most accuracy. Strength recovery in ER was associated with better Walch-Duplay and modified WOSI scores.

中文翻译：

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用于预测 Latarjet 手术后恢复运动的等速力量和平衡分析：一项前瞻性横断面研究


背景：肩部内旋（IR）和外旋（ER）等速扭矩可被视为盂肱关节动态稳定性的潜在指标。目的：评估4个月等速测试预测6个月恢复的效果- Latarjet 手术后的运动 (RTS) 状态，探索其与测试参数的相关性，并确定最佳阈值以确保安全的 RTS。 研究设计：队列研究；证据级别，2。方法：该研究评估了 2022 年 1 月至 2023 年 6 月期间接受 Latarjet 稳定手术的运动员。主要结果是术后 6 个月的 RTS。主要检查的预测指标是术后 4 个月的等速测试指标。次要结果包括改良的闭合运动链上肢稳定性测试 (mCKCUEST) 和一些患者报告的结果测量，包括 Walch-Duplay 评分、西安大略肩不稳定性指数 (WOSI) 和肩不稳定性 - 受伤后恢复运动规模。为了评估预测因素，将患者分为恢复任何级别运动的患者和未恢复运动的患者。还分析了等速测试结果与其他结果评分之间的相关性。结果：共有71名患者（平均年龄，27.43±9.09岁）纳入研究。其中，23.61%没有回归运动，38.89%回归较低水平，37.50%回归同一水平。注意到显着的旋转强度差异。 6 个月后未恢复运动的患者在 60 度/秒的同心 ER、240 度/秒的同心 ER、240 度/秒的同心 IR 和 30 度/秒的偏心 IR 方面表现出较差的强度 ( P < .05）。 所有研究的患者报告的结果指标和 mCKCUEST 都出现了类似的趋势 (P < .05)。受试者操作特征分析强调了 240 度/秒同心 ER 等速测试的重要性（曲线下面积 = 0.759；P = .001；截止值 = 0.32 N·m/kg；灵敏度 = 100.0%；特异性 = 49.1%）以及 30 deg/s 的偏心 ER（曲线下面积 = 0.760；P = .001；截止值 = 0.51 N·m/kg；灵敏度 = 94.1%；特异性 = 49.1%）进行 RTS 预测。此外，ER 强度与所有检查速度的 Walch-Duplay 评分呈中等相关（r = 0.26-0.34；P < .05）。修改后的 WOSI 评分与 240 deg/s 和 30 deg/s 的 ER 强度微弱相关（r = 0.24-0.25；P < .05），与 60 deg/s ER 的肢体对称指数中度相关和 30 deg/s ( r = 0.30-0.38; P < .05)。结论：等速测试可以作为 Latarjet 手术后成功 RTS 的独立预测因子，同心 ER 为 240 deg/s，同心 IR 为 240 deg /s、30 度/秒的偏心 ER 和 30 度/秒的偏心 IR 显示出最准确的结果。 ER 中的力量恢复与更好的 Walch-Duplay 评分和修改后的 WOSI 评分相关。