Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Rehabilitation Science

Background:

• Traumatic shoulder dislocation can lead to chronic instability.
• Effective treatment strategies are crucial for minimizing long-term dysfunction.
• Understanding treatment outcomes is vital for patient management.

Purpose of the Study:

• To compare treatments for primary traumatic shoulder dislocation to prevent chronic instability.
• To review treatments for established chronic post-traumatic shoulder instability.

Main Methods:

• Systematic review and random effects network meta-analysis.
• Included 22 randomized controlled trials.
• Searched multiple electronic databases up to January 2018.

Main Results:

• Labrum repair showed moderate evidence of reducing future dislocations (RR 0.15).
• Non-surgical management resulted in 47% of patients avoiding redislocation.
• Open surgery showed potential superiority over arthroscopic surgery for preventing redislocation (low-quality evidence).

Conclusions:

• Physiotherapy effectively prevented recurrent dislocations in approximately half of patients post-primary traumatic dislocation.
• Surgery may be considered for chronic instability.
• Limited evidence exists for surgical management of chronic post-traumatic shoulder instability.