BACKGROUND: The young athletic population makes up the largest portion of shoulder instability and, when treated nonoperatively, has a recurrent dislocation rate as high as 71%. It is unknown how the outcomes of those who have a recurrent dislocation are affected versus those who have a stabilization procedure after a first-time dislocation. PURPOSE: To report the postoperative outcomes of patients with first-time dislocations versus patients with recurrent dislocations before surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Current Procedural Terminology codes were used to identify patients who had arthroscopic Bankart repair between 2003 and 2013. A total of 173 eligible patients were identified across 8 fellowship-trained surgical practices. The first phase of the study was a retrospective chart review. Patients were identified as having a first-time dislocation or as having recurrent dislocations when they had >1 dislocation before surgical intervention. The second phase consisted of a survey to record a Simple Shoulder Test score and return to sport and to report postoperative instability and whether patients had further surgery on the shoulder. RESULTS: A total of 121 patients participated, providing 70% follow-up at an average of 51 months. There were 53 patients in the recurrent dislocation group and 68 in the first-time dislocation group. The postoperative instability rate was 29% in the first-time dislocation group and 62% in the recurrent dislocation group; this difference was significant ( P < .001). The odds of postoperative instability were 4 times higher in the recurrent dislocation group (odds ratio = 4.14). The first-time dislocation group reported a 7% rate of repeat operation to address instability, whereas the recurrent dislocation group reported a rate of 32%; this difference was significant ( P < .001). The odds of needing additional surgery on the index shoulder was 6 times higher in the recurrent dislocation group (odds ratio = 6.01). CONCLUSION: Patients with first-time dislocations had lower postoperative instability rates and reoperation rates when compared with patients with recurrent dislocations before surgery. Young patients with shoulder instability should be offered early surgical intervention to lower the risk of postoperative instability and reoperation.
BACKGROUND: The young athletic population makes up the largest portion of shoulder instability and, when treated nonoperatively, has a recurrent dislocation rate as high as 71%. It is unknown how the outcomes of those who have a recurrent dislocation are affected versus those who have a stabilization procedure after a first-time dislocation. PURPOSE: To report the postoperative outcomes of patients with first-time dislocations versus patients with recurrent dislocations before surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Current Procedural Terminology codes were used to identify patients who had arthroscopic Bankart repair between 2003 and 2013. A total of 173 eligible patients were identified across 8 fellowship-trained surgical practices. The first phase of the study was a retrospective chart review. Patients were identified as having a first-time dislocation or as having recurrent dislocations when they had >1 dislocation before surgical intervention. The second phase consisted of a survey to record a Simple Shoulder Test score and return to sport and to report postoperative instability and whether patients had further surgery on the shoulder. RESULTS: A total of 121 patients participated, providing 70% follow-up at an average of 51 months. There were 53 patients in the recurrent dislocation group and 68 in the first-time dislocation group. The postoperative instability rate was 29% in the first-time dislocation group and 62% in the recurrent dislocation group; this difference was significant ( P < .001). The odds of postoperative instability were 4 times higher in the recurrent dislocation group (odds ratio = 4.14). The first-time dislocation group reported a 7% rate of repeat operation to address instability, whereas the recurrent dislocation group reported a rate of 32%; this difference was significant ( P < .001). The odds of needing additional surgery on the index shoulder was 6 times higher in the recurrent dislocation group (odds ratio = 6.01). CONCLUSION:Patients with first-time dislocations had lower postoperative instability rates and reoperation rates when compared with patients with recurrent dislocations before surgery. Young patients with shoulder instability should be offered early surgical intervention to lower the risk of postoperative instability and reoperation.
Authors: Mohammed Adam; Ahmed Khalil Attia; Abduljabbar Alhammoud; Osama Aldahamsheh; Mohammed Al Ateeq Al Dosari; Ghalib Ahmed Journal: Int Orthop Date: 2018-07-07 Impact factor: 3.075
Authors: Mitchell I Kennedy; Colin Murphy; Grant J Dornan; Gilbert Moatshe; Jorge Chahla; Robert F LaPrade; Matthew T Provencher Journal: Orthop J Sports Med Date: 2019-05-30
Authors: Peter N Chalmers; William Uffman; Garrett Christensen; Patrick Greis; Stephen Aoki; Richard Nelson; Minkyoung Yoo; Robert Z Tashjian Journal: JSES Int Date: 2020-03-16
Authors: Alexandre Hardy; Vincent Sabatier; Pierre Laboudie; Bradley Schoch; Geoffroy Nourissat; Philippe Valenti; Jean Kany; Julien Deranlot; Nicolas Solignac; Philippe Hardy; Marie Vigan; Jean-David Werthel Journal: Am J Sports Med Date: 2019-10-24 Impact factor: 6.202
Authors: Peter N Chalmers; Bradley Hillyard; Jun Kawakami; Garrett Christensen; Dillon O'Neill; Victoria Childress; Robert Z Tashjian Journal: JSES Int Date: 2020-05-30