[Current treatment concepts in first-time dislocation of the shoulder joint]

The rapid development of arthroscopic techniques has raised questions on the treatment of first shoulder dislocations. Primary arthroscopic or even open labral repair have been recommended. However, the available prospective studies demonstrate a recurrence rate of not more than 50% in the global population. This number increases steeply if certain risk factors are present: young age (under 25 years), shoulder sports, adequate trauma with acute unidirectional instability. For this selected group, arthroscopic labral repair should be proposed and should be performed by a surgeon specifically trained in this advanced arthroscopic technique. Repair of the labrum is feasible with various arthroscopic techniques, whereas the shortening of redundant capsular areas still poses problems. The efficiency of laser- or heat-shrinking of the shoulder capsule must yet be proven.