{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:33:31Z","timestamp":1773383611977,"version":"3.50.1"},"reference-count":72,"publisher":"Korean Shoulder and Elbow Society","issue":"1","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["cisejournal.org"],"crossmark-restriction":true},"short-container-title":["Clin Shoulder Elb"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:p>Background: We aimed to review all published evidence on the surgical management of internal impingement and associated conditions in athletes of overhead sports.Methods: Our search included studies reporting outcomes of any surgical intervention on shoulder internal impingement and its sequelae in overhead athletes. The primary outcome was return to sport at pre-injury level or higher in the main text (RTS+). Secondary outcomes included return to sport at any level (RTS), shoulder function, and complications. No quantitative analyses were possible due to the nature of the evidence included.Results: Forty-two observational studies were eligible. They included 1,420 overhead athletes with a mean age of 27.3 years. RTS+ across all surgical procedures ranged from 25% to 94%. In patients treated with debridement of articular-sided partial-thickness rotator cuff tears, the RTS+ ranged from 50% to 85%, and in those who underwent posterior glenoidplasty for glenoid spurs, it ranged from 55% to 63.6%. Comparative studies for superior labrum anterior to posterior (SLAP) tears demonstrated similar RTS+ after open subpectoral tenodesis and arthroscopic SLAP repair. RTS+ after the two procedures in all observational studies ranged from 35% to 100% and 54.2% to 100%, respectively. RTS+ after capsulorrhaphy, when performed concomitantly with other procedures, ranged from 25% to 93%.Conclusions: Outcomes associated with the surgical management of internal impingement are variable. Surgical decision-making should prioritize patient-specific factors following unsuccessful conservative management. We provide surgical recommendations and considerations.<\/jats:p>","DOI":"10.5397\/cise.2025.01123","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T03:53:29Z","timestamp":1770954809000},"page":"115-133","update-policy":"https:\/\/doi.org\/10.5397\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of internal impingement in overhead athletes: a systematic 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