Arthroscopically Determined Degree of Injury After Shoulder Dislocation Relates to Recurrence Rate

Abstract

Background The glenohumeral joint is the most mobile articulation in the body and the most commonly dislocated diarthrodial joint with peaks in the incidence of dislocation occurring during the second and sixth decades. Age at the time of the initial dislocation is inversely related to the recurrence rate. Traumatic anterior instability is often associated with intraarticular injuries. The frequency of injuries may increase with dislocation or subluxation episodes. Questions/purposes We compared the frequency of lesions associated with traumatic anterior instability in patients with primary and recurrent instability. Methods We retrospectively reviewed 96 selected patients with traumatic anterior instability treated arthroscopically between 2005 and 2008. Forty-five had arthroscopy after a first episode of dislocation (Group I) and 51 had two or more episodes of instability (Group II). We compared the frequencies and percentage of intraarticular lesions in both groups. Results We observed a Bankart lesion in all patients of both groups. The posterior Bankart lesion was observed more frequently in Group II than in Group I: 47% versus 28%. SLAP lesions were observed in 12% in Group I and 24% in Group II. In 10 patients in Group II, there was an associated rotator cuff tear. Conclusions Patients with recurrent shoulder dislocation had a higher arthroscopic degree of injury. These patients presented more posterior labral lesions, SLAP tears, and rotator cuff pathology than patients with a first episode of shoulder dislocation.

Surgical stabilization for first-time shoulder dislocators: a multicenter analysis

“…They proposed a progressive degenerative process of the labrum-ligament complex, which correlated with number of recurrences. Gutierrez et al 20 retrospectively compared intra-articular findings in 45 first-time dislocators and 51 recurrent dislocators who underwent arthroscopy. They found a higher incidence of SLAP tears and rotator cuff tears among recurrent dislocators.…”

Interest of emergency arthroscopic stabilization in primary shoulder dislocation in young athletes

“…At each recurrence, passing lesions are exacerbated, with labral damage, capsule stretching and glenoid bone lesions and notching [52,53], reducing the chances of successful arthroscopic stabilization. Samilson and Prieto were the first to introduce the notion of shoulder osteoarthritis induced by instability [54].…”

THE GLENOID NOTCH AND ITS CLINICAL IMPLICATIONS. La muesca glenoidea y sus implicaciones clínicas.

“…Due the presence of the rotator cuff muscles both Palastanga et al (2006) and Sinnatamby (2006) assume that anterior dislocation of the shoulder is not common. However, Cutts et al (2009), Bankart (1923), Ufberg et al (2004), Chechik et al (2011) and Gutierrez et al (2012) disagree stating that as the shoulder joint is the most mobile joint in the body anterior dislocation accounts for the majority of dislocations and occur predominately in males. The current study found that females were significantly more likely to have a type I or II glenoid notch and males significantly more likely to have a type III glenoid notch.…”

“…The peak incidence of shoulder joint dislocation occurs between 20 and 60 years of age. Anterior dislocation accounts for the majority of shoulder dislocations which predominately occur in males (Milgrom et al, 2014;Cutts et al, 2009;Bankart, 1923;Ufberg et al, 2004;Chechik et al, 2011;Gutierrez et al, 2012). The recurrence rate of anterior glenohumeral dislocation after initial dislocation in young athletes is between 54% and 92% (Wheeler et al, 1989;Bottoni et al, 2002;Te Slaa et al, 2003;Jakobsen et al, 2007).…”