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Predicting recurrence of instability after a primary traumatic anterior shoulder dislocation
Navnit S Makaram1,2, Hannes Becher2, Erlend Oag1
1Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
The Bone & Joint Journal
|September 30, 2024
Summary
Recurrent instability after shoulder dislocation is common, affecting 62.8% of patients. Key risk factors include male sex, young age, and contact sports, but predicting recurrence remains difficult.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Trauma Care
Background:
- Recurrent instability (RI) following primary traumatic anterior shoulder dislocation (PTASD) is a significant concern.
- Identifying risk factors for RI is crucial for effective patient management and prevention strategies.
Purpose of the Study:
- To determine the rate of RI in a large cohort of patients managed nonoperatively after PTASD.
- To develop a clinical prediction model for RI after PTASD.
Main Methods:
- A retrospective analysis of 1,293 patients with PTASD managed nonoperatively.
- Multivariate regression modeling was used to identify independent predictors of RI.
Main Results:
- The overall rate of RI was 62.8%, with most recurrences occurring within two years.
- Independent predictors for RI included male sex, younger age, contact sport participation, and bony Bankart lesions.
- Greater tuberosity fracture was found to be protective against RI.
Conclusions:
- This study identifies key risk factors for RI after PTASD in a large patient cohort.
- While a predictive model was developed, its discriminative ability was poor, indicating challenges in predicting RI.
- Further research is needed to identify additional risk factors for recurrent shoulder instability.
