Long-term result after traumatic anterior shoulder dislocation: what works best?

Tongel, Alexander Van; Rosa, Francesco Della; Heffernan, Greg; Levy, Ofer; Sforza, Giuseppe

doi:10.1007/s12306-011-0125-8

Cited by 11 publications

(9 citation statements)

References 44 publications

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“…The operative management of traumatic anterior glenohumeral instability has evolved from open to arthroscopic stabilization techniques. However, controversy over the results of open or arthroscopic shoulder stabilization still exists [1][2][3][4] . Advocates of arthroscopy cite faster recovery, less postoperative pain, decreased operative time, improved cosmetic appearance, improved range of shoulder motion, and more accurate identification of intra-articular pathology 1,5,6 .…”

mentioning

confidence: 99%

A Randomized Clinical Trial Comparing Open and Arthroscopic Stabilization for Recurrent Traumatic Anterior Shoulder Instability

Mohtadi

Chan

Hollinshead

et al. 2014

Journal of Bone and Joint Surgery

133

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mentioning

confidence: 99%

A Randomized Clinical Trial Comparing Open and Arthroscopic Stabilization for Recurrent Traumatic Anterior Shoulder Instability

Mohtadi

Chan

Hollinshead

et al. 2014

Journal of Bone and Joint Surgery

133

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“…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%

“…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. Moreover, the 19 % with instability after 5 years should be critically discussed despite the good results of the remaining patients.…”

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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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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“…[6] have suggested that labral, ligamentous and osseous pathology in shoulder instability are time- and recurrence dependent. Therefore, it appears to be the sub-group of young athletic males engaged in demanding activities that may profit more from rather early operative management of shoulder instability [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

“…Avoiding numerous pre-operative dislocations appears to prevent to some extent the occurrence and severity of post-operative dislocation arthropathy [19]. One should point out however that the clinical significance of radiologically evident dislocation arthropathy is debatable, as Constant score results do not seem to correlate with the presence or grade of postoperative dislocation arthropathy [8, 19]. …”

Section: Introductionmentioning

confidence: 99%

Long Term Outcomes of Arthroscopic Shoulder Instability Surgery

Karataglis

Agathangelidis

2017

TOORTHJ

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Background:Anterior shoulder instability has been successfully managed arthroscopically over the past two decades with refined “anatomic” reconstruction procedures involving the use of anchors for the repositioning and re-tensioning of the antero-inferior capsuloligamentous complex, in an effort to recreate its “bumper effect”.Methods:Research and online content related to arthroscopic treatment of shoulder instability was reviewed and their results compared.Results:The short- and mid-term results of this technique have been very satisfactory. The greatest number of recent reports suggests that long-term results (>5 years follow-up) remain rather satisfactory, especially in the absence of significant glenoid bone loss (>20-25%). In these studies recurrent instability, in the form of either dislocation or subluxation, ranges from 5.1 to over 20%, clinical scores, more than 5 years after the index procedure, remain good or excellent in >80% of patient population as do patient satisfaction and return to previous level of activities.As regards arthroscopic non-anatomic bony procedures (Latarjet or Bristow procedures) performed in revision cases or in the presence of >20-25% bone loss of the anteroinferior aspect of the glenoid, recent reports suggest that their long-term results are very satisfactory both in terms of re-dislocation rates and patient satisfaction.Conclusion:It appears that even “lege artis” performance of arthroscopic reconstruction decelerates but does not obliterate the degenerative procedure of dislocation arthropathy. The presence and grade of arthritic changes correlate with the number of dislocations sustained prior to the arthroscopic intervention, the number of anchors used and the age at initial dislocation and surgery. However, the clinical significance of radiologically evident dislocation arthropathy is debatable.

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Long-term result after traumatic anterior shoulder dislocation: what works best?

Cited by 11 publications

References 44 publications

A Randomized Clinical Trial Comparing Open and Arthroscopic Stabilization for Recurrent Traumatic Anterior Shoulder Instability

A Randomized Clinical Trial Comparing Open and Arthroscopic Stabilization for Recurrent Traumatic Anterior Shoulder Instability

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

Long Term Outcomes of Arthroscopic Shoulder Instability Surgery

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