Primary Arthroscopic Stabilization for a First-Time Anterior Dislocation of the Shoulder

Robinson, C. M.; Jenkins, Paul J.; White, T O; Ker, Andrew; Will, E.

doi:10.2106/jbjs.g.00679

Cited by 181 publications

(154 citation statements)

References 35 publications

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“…These five recurrent instabilities indicate a total instability of 19 %, which is comparable with previously described recurrence rates from other studies investigating immobilization in external rotation of shorter follow-up periods and in similar patients of average age [3,4,7] (see also Table 2). As well as in the immobilization of internal rotation [22] or in the operative treatment groups [24], our data show that in external rotation the majority of re-dislocations occur within the first 2 years after initial trauma (3-24 months, ø 12.2 months). The specific reasons for the re-dislocation or instability remain difficult to determine.…”

Section: Discussionmentioning

confidence: 71%

“…The most recently published studies by Finestone et al [6] and Liavaag et al [7] deemed the operative treatment to be the more efficient treatment for primary traumatic dislocation, even though a direct comparison between immobilization in external rotation and surgery is not available as a randomized controlled trial. In contrast to immobilization in internal rotation, recurrence rates of operative treatment are clearly superior [24,[26][27][28]. Although the risks for surgery, especially in arthroscopic stabilization, are low [28][29][30], these risks have to be considered and disclosed to the patient during the decision-making process.…”

Section: Studymentioning

confidence: 99%

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Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results

et al. 2013

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Background It is still not clear which method is the most efficient for treating primary traumatic anterior shoulder dislocation. Immobilization in external rotation has become increasingly discussed within the last 10 years. The aim of this study was to evaluate the rate of recurrence and clinical outcome of the immobilization in external rotation after primary traumatic anterior dislocation within a midterm period of 5 years. Additionally, a summary of literature is given according to the present knowledge of this issue.Methods From May 2004 to May 2006, 28 patients with primary traumatic anterior shoulder dislocations were included in a prospective MRI-controlled study. After a follow-up of 5 years, the recurrence rate and clinical outcomes of the patients were evaluated using clinical scores (Constant and Murley score, Western Ontario Shoulder Instability Index, Rowe score).Results After 5 years, 26 patients (93 %; males, n = 25; female, n = 1; mean age, 29.3 years) were interviewed concerning re-dislocations. In the meantime, four patients (15 %) experienced a re-dislocation (ø 12.2 months) after the end of the immobilization. Overall, 21 patients (75 %) were included in a clinical follow-up (CM score: ø 92.8 points; Western Ontario Shoulder Instability Index: ø 87 %; Rowe score (in 17 patients): ø 94.2 points). Upon clinical examination, unidirectional anterior instability was found in one patient, which corresponds to an overall instability rate of 19 % within the examined patient population including the re-dislocations.Conclusions Immobilization in external rotation shows satisfactory results after 5 years in regard to recurrence and instability rates and clinical outcomes. The data show that with immobilization in external rotation, re-dislocations occur within the first 2 years.

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Section: Discussionmentioning

confidence: 71%

Section: Studymentioning

confidence: 99%

Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results

et al. 2013

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“…[30] Bankart lesion repair by arthroscopy [34] Case Procedure: Return of dislocation [1] Control Procedure: Return of dislocation [2] Limitation of external rotation [1] Robinson et al 2008 Bankart lesion repair by arthroscopy [39] Case Procedure: Recurring dislocation [3] Pain and stiffness [4] Need for surgical repair [1] Control Procedure: Recurring anterior dislocation [24] Subjective instability [1] Pain and stiffness [4] Bottoni et al 2002…”

Section: Resultsmentioning

confidence: 99%

Complications of Surgical Treatment of Anterior Shoulder Dislocation: A Systematic Review

Nascimento¹,

Castro²,

Pereira³

et al. 2017

OJO

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Introduction: shoulder joint has the greatest range of motion in the human body. The shoulder anatomy promotes high mobility and favors relative sacrifice of articular stability, making it susceptible and more prone to events of instability and dislocation. This review aimed at identifying main complications of surgical treatment of anterior shoulder dislocation. Methodology: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Studies which were eligible for this systematic review included: English or Spanish language, studies published from 2000, which mentioned surgical complications of anterior shoulder dislocation in their results, both in open and arthroscopic surgery. Included studies which were required to have at least 1 complication following surgical repair. Only studies from original data were included. Results: We found 228 potentially eligible studies for the survey. Through the inclusion and exclusion criteria and after consensus among reviewers, we chose 9 studies to compose the systematic review. Conclusion: Important information emerges: recurring instability, recurring dislocation, external rotation limitation and arthritis are main surgical complications of anterior shoulder dislocation.

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“…A study by Wintzell et al, which aimed to evaluate the effect of arthroscopic lavage as a form of treatment for acute anterior glenohumeral dislocation, reported a recurrence rate of 43% in patients who received nonsurgical treatment, while that of patients who received arthroscopic lavage was only 13%. (26) Robinson et al (27) found that arthroscopic repair of a Bankart lesion after primary traumatic anterior shoulder dislocation reduced the risk of recurrence by 76%; they also found that the risk of all recurrent instability was reduced by 82% in this group of patients that underwent Bankart repair, as compared to the group that underwent arthroscopy and lavage alone. They concluded that marked treatment benefit could be derived from primary arthroscopic repair of a Bankart lesion, distinct from the so-called background therapeutic effect of arthroscopic examination and lavage of the joint.…”

Section: Surgical Treatmentmentioning

confidence: 92%

“…However, they noted that primary repair did not appear to confer a functional benefit to patients with a stable shoulder at two years after the dislocation. (27) In a study that evaluated the results of early arthroscopic Bankart repair in patients with primary traumatic anterior dislocation of the shoulder, Valentin et al (28) found that 93% of their patients had good or excellent results at 18 months. In addition, 83% of their patients returned to their pre-dislocation activity level.…”

Section: Surgical Treatmentmentioning

confidence: 99%

First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

Sedeek¹,

Razak²,

Gw³

et al. 2014

smedj

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The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilisation for 4-6 weeks, followed by functional rehabilitation. However, in view of the high recurrence rates associated with this traditional approach, there has been an escalating interest in determining whether immediate surgical intervention can lower the rate of recurrent shoulder dislocation, improving the patient's quality of life. This review article aims to provide an overview of the nature and pathogenesis of first-time primary anterior shoulder dislocations, the widely accepted management modalities, and the efficacy of primary surgical intervention in first-time primary anterior shoulder dislocations.

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Primary Arthroscopic Stabilization for a First-Time Anterior Dislocation of the Shoulder

Cited by 181 publications

References 35 publications

Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results

Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results

Complications of Surgical Treatment of Anterior Shoulder Dislocation: A Systematic Review

First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

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