Comparison of Revision and Redislocation Rates After First-Time Anterior Shoulder Instability Between Subluxators and...

Area of Science:

• Orthopedics
• Sports Medicine
• Shoulder Surgery

Background:

• Anterior shoulder instability is prevalent in young, active individuals.
• Distinguishing between first-time subluxation and dislocation impacts understanding of shoulder stability.
• Limited data exists on comparative outcomes after surgical stabilization for these initial events.

Purpose of the Study:

• To compare revision and redislocation rates between patients experiencing first-time shoulder subluxation versus dislocation.
• To evaluate patient-reported outcomes (PROs) in these two distinct first-time instability cohorts.

Main Methods:

• A cohort study (Level of evidence, 3) analyzed patients with first-time anterior instability undergoing surgery (2013-2020).
• Instability was classified as subluxation or dislocation based on clinical documentation.
• Data included demographics, surgical details, preoperative imaging (MRI), and prospective PROs, return-to-sport, redislocation, and revision rates.

Main Results:

• 256 patients (141 subluxators, 115 dislocators) were analyzed; demographics and exam findings were similar.
• Hill-Sachs lesions were more frequent in dislocators (88.7%) than subluxators (53.9%) (P < .01).
• Midterm follow-up showed comparable rates of recurrent dislocation (11.8% vs 20.0%) and revision surgery (8.8% vs 16.0%) between subluxators and dislocators, respectively. All PROs and return-to-sport rates were also similar.

Conclusions:

• First-time subluxation and dislocation events may result in similar midterm outcomes regarding redislocation and revision surgery.
• Injury characteristics and patient-reported outcomes appear comparable between the two groups.
• Further prospective research is recommended to validate these findings for first-time shoulder instability events.