Management of a first-time shoulder dislocation in the athlete: From ER to OR

Management of first-time shoulder dislocations in young active patients presents a significant challenge due to the high likelihood of recurrent anterior shoulder instability. Repeated instability events can result in poor outcomes because each dislocation contributes dose-dependent damage to the glenohumeral joint. Various validated techniques are available for reducing glenohumeral dislocations. For in-season athletes sustaining a shoulder dislocation, management requires balancing a rapid return to play with the heightened risk of recurrent instability. In-season surgical management is typically reserved for athletes experiencing recurrent instability or substantial osseous deficits. When surgical intervention is necessary, the approach is guided by the extent of critical glenoid bone loss and whether the humeral head bone defect engages with the glenoid.