Arthroscopic Treatment of First-Time Shoulder Dislocations in Younger Athletes

Abstract

Background: The glenohumeral joint is characterized by its large degree of movement and consequently is the most susceptible joint to dislocations. There are few studies on the first episode of a shoulder dislocation in younger athletes. Purpose: To report the results of arthroscopic treatment for the first episode of a glenohumeral dislocation in younger athletes. Study Design: Case series; Level of evidence, 4. Methods: In this retrospective study, 53 patients younger than 40 years (N = 54 shoulders) sustained their first anterior shoulder dislocation and underwent arthroscopic surgery. Surgery was undertaken in the lateral decubitus position. Standard posterior, anteroinferior, and anterosuperior portals were used, and the number of anchors and the degree of capsular plication were individualized and based on the arthroscopic findings of each patient. The minimum follow-up was 2 years (mean, 2.31 years), and patients were evaluated with the Rowe functional score, Athletic Shoulder Outcome Rating Scale (EROE; acronym in Portuguese), and visual analog scale (VAS) for pain. Results: The mean EROE score was 93.8, with 98% of results being good or excellent, and the mean Rowe score was 95.0, with 98% good or excellent results. The mean VAS pain score was <1.0. The rate of recurrence of dislocations was 2%. The return-to-sports rate was 83%; patients with associated superior labral anterior-posterior (SLAP) lesions had a lower return-to-sports rate ( P = .001) and lower EROE ( P = .017) and Rowe ( P = .019) scores. Conclusion: The present study showed favorable results for arthroscopic surgical treatment after the first dislocation episode in young athletes. It was an effective and safe treatment option in this population.

Immobilization in external rotation vs internal rotation after shoulder dislocation

“…With the largest range of motion and relatively low stability, shoulder joint is the most prone to dislocation. [1,2] Shoulder dislocation, nearly 90% to 95% of anterior dislocation, [2,4] accounts for about 45% of all dislocation in orthopedics, [3] which is predominant in young people. [1,5] It is more than triple the incidence rate for women.…”

“…[1,2] Shoulder dislocation, nearly 90% to 95% of anterior dislocation, [2,4] accounts for about 45% of all dislocation in orthopedics, [3] which is predominant in young people. [1,5] It is more than triple the incidence rate for women. [6] According to Kirkley's study, the occurrence of 1st shoulder dislocation is 8 to 8.2/100,000 people/year.…”

Can We Identify Why Athletes Fail to Return to Sports After Arthroscopic Bankart Repair? A Systematic Review and Meta-analysis

“…Shoulder instability is particularly debilitating for athletes, often leading to time lost from play, 13,48,50 diminished performance, 12,30,35 and a potential end to an athlete’s career. 38,39,51 Beyond physical limitations attributed to shoulder instability, athletes may exhibit apprehension of future injury that may affect play, constituting a significant mental obstacle for the recovering athlete to overcome.…”

“…38,39,51 Beyond physical limitations attributed to shoulder instability, athletes may exhibit apprehension of future injury that may affect play, constituting a significant mental obstacle for the recovering athlete to overcome. 24,48,49 Additionally, early diagnosis and management are paramount, as untreated instability can increase risk of further shoulder injury. 7,12,50…”

“…12,54 This incidence is estimated to be even higher among at-risk populations, such as athletes participating in collision sports (0.51 per 1000 athleteexposures) 13 and military personnel (169 per 100,000 person-years). 35 Shoulder instability is particularly debilitating for athletes, often leading to time lost from play, 13,48,50 diminished performance, 12,30,35 and a potential end to an athlete's career. 38,39,51 Beyond physical limitations attributed to shoulder instability, athletes may exhibit apprehension of future injury that may affect play, constituting a significant mental obstacle for the recovering athlete to overcome.…”