Who Should Have Surgery to Prevent Shoulder Re-Dislocation?Is it possible to predict who might dislocate the shoulder a second time? Should surgery be done to keep this from happening? These are the questions the authors of this study attempted to answer.
Surgery to repair damage to the shoulder could save the patient the suffering of re-dislocation and the cost of multiple doctor visits. But it's important to avoid surgery when it's not needed, too.
There were 131 patients in the study who had first-time shoulder dislocations. Data of all kinds was collected on everyone. Age, body type, joint flexibility, and occupation were just a few pieces of information collected. A detailed report of the dislocation event and type of damage done to the joint was also included. The number of sports hours played was also recorded.
Everyone was followed for at least two years. A research assistant telephoned each patient every six months to ask a few questions. The authors thought it would be better to avoid relying on the patient's memory and collect the data directly instead.
Some patients were still in the study for five years. Each patient was asked to come back to the clinic for a follow-up exam. Analyzing the data and looking back, there wasn't really a way to predict who might dislocate the shoulder again.
Younger patients who were involved in contact or collision sports were more likely to re-dislocate the shoulder. The same was true for younger patients whose job required them to work with their arms overhead. But not all of these patients needed surgery, so these factors aren't enough to suggest surgery is needed.
Those who did have surgery did not dislocate the shoulder again. And looking back over all the data, the researchers were never able to see any differences between those who had surgery and those who didn't that might help predict future instability.
Raymond A. Sachs, MD, et al. Can the Need for Future Surgery for Acute Traumatic Anterior Shoulder Dislocation Be Predicted? In The Journal of Bone and Joint Surgery. August 2007. Vol. 89-A. No. 8. Pp. 1665-1674.
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