Arthroscopic Posterior Labral Repair in Professional Contact Athletes Restores Shoulder Stability and Enables Successful Return to Pre-injury Competition.

Purpose: To evaluate return-to-competition rates, posterior shoulder instability recurrences, and revision surgeries following arthroscopic posterior labral repair in this elite cohort. Methods: A retrospective review of prospectively collected data included professional contact athletes undergoing primary arthroscopic posterior labral repair by a single surgeon (June 2016 to February 2024). Inclusion required age ≥18, active professional status at surgery, and minimum 12-month follow-up. Patients with concomitant cuff repairs or bony procedures were excluded. Outcomes included return-to-competition (defined as the first postoperative professional game), time to return-to-competition, instability recurrence, games per season, and career longevity using public performance data. Results: Seventeen professional male contact-sport athletes (mean age 24 ± 3.7 years) met inclusion criteria. Ten were National Hockey League hockey players and 7 were National Football League football players. All (100%) returned to their pre-injury level at a median of 173 days (range 89-370 days). At mean follow-up of 45 ± 22.9 months, 1 athlete experienced recurrent instability, which was managed nonoperatively. No athlete retired postoperatively. Fourteen of 17 played more games per season following surgery, with a mean increase of 26.6% ± 21.8%. Conclusions: Arthroscopic posterior labral repair is a highly effective surgical intervention for restoring shoulder stability and enabling a reliable return to play among professional contact-sport athletes. In this cohort of elite-level, professional competitors, most athletes returned to their pre-injury level of competition and continued playing without issue, with only 1 case of recurrent instability that did not require revision surgery at a minimum 1-year follow-up. Level of Evidence: Level IV, retrospective therapeutic case series.