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Current Concepts in the Management of Shoulder Instability
Suresh Srinivasan1, Radhakant Pandey1
1Upper Limb Unit, Department of Trauma and Orthopaedic Surgery, Musculoskeletal Directorate, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
Indian Journal of Orthopaedics
|October 3, 2017
Summary
Managing traumatic shoulder instability requires a personalized approach, emphasizing clinical examination over imaging. This review simplifies current evidence for athletes, focusing on surgical options for shoulder dislocation.
Area of Science:
- Orthopedics
- Sports Medicine
- Surgical Innovation
Background:
- Shoulder instability presents a spectrum from subtle issues to dislocations, posing management challenges.
- Factors influencing management include patient lifestyle, increased awareness, and advanced imaging.
- Clinical assessment remains crucial, with a need to balance it against imaging reliance.
Purpose of the Study:
- To review and simplify current evidence on managing traumatic shoulder instability.
- To focus on surgical management strategies, particularly for athletes.
- To highlight the importance of individualized treatment plans and shared decision-making.
Main Methods:
- Systematic literature search using Embase, PubMed, Medline, CINAHL, Cochrane Library, SIGN, and Google Scholar.
- Keywords included shoulder instability, dislocation, sports injuries, surgery, Latarjet, glenohumeral, glenoid, and arthroscopy (1980-March 2017).
- Initial search yielded 310 publications; 20 full-text articles focusing on surgical management were selected.
Main Results:
- The majority of selected studies focused on surgical interventions for traumatic shoulder instability.
- Evidence suggests a tailor-made approach is essential for optimal patient outcomes.
- Shared decision-making between patient and clinician is a key component of management.
Conclusions:
- A personalized, evidence-based approach is vital for managing traumatic shoulder instability in athletes.
- Surgical management options are central to the current evidence base.
- Integrating clinical expertise with patient-specific factors optimizes treatment strategies.
