Recurrent Shoulder Instability in a Young, Active, Military Population and Its Professional Implications

Area of Science:

• Sports Medicine
• Orthopedic Surgery
• Occupational Health

Background:

• Shoulder instability is a prevalent issue in sports medicine, with ongoing research into recurrence rates and optimal treatments.
• Limited data exists on the occupational consequences of symptomatic recurrent shoulder instability.

Purpose of the Study:

• To investigate the recurrence rates of shoulder instability in young, active individuals following surgical repair.
• To determine the impact of recurrent shoulder instability on college graduation and postgraduate occupational selection.

Main Methods:

• Retrospective review of medical waivers for surgical treatment of anterior shoulder dislocation/instability at US military academies (2010-2013).
• Statistical analysis to identify incidence, risk factors for recurrence, and effects on graduation and occupation selection.
• Case series with Level 4 evidence.

Main Results:

• 34% of evaluated patients experienced recurrent anterior instability.
• Patients with prior arthroscopic repair showed a significantly higher recurrence rate (38%).
• Recurrent instability did not significantly affect graduation rates or self-selected occupations.

Conclusions:

• A significant rate of recurrent shoulder instability exists post-surgery, particularly in young, active populations.
• Arthroscopic repair was associated with a higher recurrence rate than open repair in this cohort.
• Surgical repair for shoulder instability should not deter individuals from pursuing high-risk occupations.