Prognosis in Dislocations of the Shoulder

Rowe, Carter R.

doi:10.2106/00004623-195638050-00001

Cited by 613 publications

(321 citation statements)

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“…There are similar rates of a single dislocation event among patients older or younger than 45 years [35]. After an anterior dislocation, McLaughlin [26] postulated that in younger patients the anterior capsulolabral structures most commonly fail.…”

Section: Introductionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

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Background The rotator cuff plays a significant role in the static and dynamic stability of the glenohumeral joint. Rotator cuff tears may occur after shoulder dislocations, whether in younger athletes or older patients with agerelated tendon degeneration. Untreated tears may cause persistent pain, dysfunction, instability, and degenerative changes. A thorough understanding of when to look for rotator cuff tears after shoulder dislocations and how best to manage them may decrease patients' pain and improve function. Questions/purposes We systematically reviewed the available literature to better understand (1) when a rotator cuff tear should be suspected after a dislocation, (2) whether surgical or nonsurgical approaches result in better scores for pain and satisfaction in patients with rotator cuff tears resulting from shoulder dislocations, and (3) whether intraarticular lesions, rotator cuff tears, or both should be addressed when surgery is performed. Methods We systematically searched MEDLINE 1 , CI-NAHL, and EMBASE for studies published from 1950 to 2012. We included studies reporting outcomes after treatment in patients with rotator cuff tears and shoulder dislocations. We excluded case reports, studies without any treatment, and studies about patients treated with arthroplasty. Five Level III and six Level IV studies were ultimately selected for review. Results Patients with persistent pain or dysfunction after a shoulder dislocation often had a concomitant rotator cuff tear. Surgical repair resulted in improved pain relief and patient satisfaction compared to nonoperative management. Repair of the rotator cuff, along with concomitant capsulolabral lesions, helped restore shoulder stability. While these findings are based on Level III and IV evidence, better long-term studies with larger cohorts are needed to strengthen evidence-based recommendations. Conclusions Persistent pain and dysfunction after a shoulder dislocation should prompt evaluation of the rotator cuff, especially in contact or overhead athletes, patients older than 40 years, or those with nerve injury. Surgery should be considered in the appropriately active patient with a rotator cuff tear after dislocation. While the current literature suggests improved stability and function after surgical repair of the rotator cuff, higher-quality prospective studies are necessary to make definitive conclusions.

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Section: Introductionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

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“…The incidence of recurrent dislocation ranges from 17-96% with a mean of 67% in patient populations between the ages of 21-30 years old. 1,[5][6][7][8][9][10][11][12][13][14][15] Therefore, the rehabilitation program should progress cautiously in young athletic individuals. It should be noted that Hovelius et al 8,16,17 has demonstrated that the rate of recurrent dislocations is based on the patient's age and not affected by the length of post-injury immobilization.…”

Section: Frequency Of Dislocationmentioning

confidence: 99%

“…The three most common forms include anterior, posterior, and multidirectional. Anterior instability is the most common traumatic type of instability seen in the general orthopaedic population, representing approximately 95% of all traumatic shoulder instabilities 12 . Following a traumatic event in which the humeral head is forced into extremes of abduction and external rotation, or horizontal abduction, the glenolabral complex and capsule may become detached from the glenoid rim resulting in anterior instability.…”

Section: Direction Of Instabilitymentioning

confidence: 99%

Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

Wilk

Macrina²,

Reinold³

2012

Shoulder Instability: A Comprehensive Approach

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“…The reported incidence of recurrent instability varies widely in the literature with rates ranging from 17% to almost 100% [10,14,18,21,25]. Several authors have identified youth, male gender, early return to competitive contact sport, and poor compliance with a rehabilitation protocol as risk factors for recurrent dislocation [11,17].…”

Section: Introductionmentioning

confidence: 99%

Do Patients With Traumatic Recurrent Anterior Shoulder Instability Have Generalized Joint Laxity?

Ranalletta¹,

Bongiovanni²,

Suarez³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background A number of studies suggest a relationship between generalized joint laxity (GJL) and increased risk of some musculoskeletal injuries. However, there are conflicting data on the association between GJL and traumatic recurrent shoulder instability (RSI). Questions/purposes We therefore asked whether the incidence of GJL in patients with RSI was greater than that in a control group. Methods We preoperatively determined GJL with a Beighton score in 100 male patients arthroscopically treated for RSI. The mean age of the patients was 25 years. We identified a control group of 100 individuals, matched for age and gender, with no known history of instability of the shoulder, knees, or ankles and obtained the same score. Those patients with a Beighton score greater than six points were considered lax (representing GJL).

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Prognosis in Dislocations of the Shoulder

Cited by 613 publications

References 0 publications

Rotator Cuff Tear and Glenohumeral Instability

Rotator Cuff Tear and Glenohumeral Instability

Nonoperative rehabilitation for traumatic and atraumatic glenohumeral instability

Do Patients With Traumatic Recurrent Anterior Shoulder Instability Have Generalized Joint Laxity?

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