[Recurrent anterior luxation of the shoulder occurring after the age of 40].

Twenty-four recurrent dislocations of the shoulder with an onset after the age of 40 years have been operated on using the Trillat technique. The results have been studied with a mean follow-up of 10 years. This type of lesion, which is not rare, forming five per cent of cases in the authors series between 1953 and 1982, deserves separate consideration because of the frequency of associated rupture of the rotator cuff which seems to arise as a consequence of the first dislocation. There were 75 per cent of indirect tuberosity signs and 20 per cent of elevations of the humeral head before operation. It is responsible for osteoarthritis in the shoulder found in the follow-up. There were 70 per cent of osteoarthritic shoulders and 50 per cent of cases with elevation of the humeral head. The clinical results obtained, without any associated procedures on the cuff, were investigated by the criteria established for the surgery of shoulder instability (Rowe). They were satisfactory, with 63 per cent of good objective results and 88 per cent of satisfied patients. There appears to be a beneficial effect from the downward displacement of the subscapularis which should be taken into account as well as consideration of treatment for the lesions of the rotator cuff.