Arthroscopic surgery, surgery where the doctor makes a few tiny incisions and uses long, narrow instruments to perform the surgery, is an increasingly popular option when it is possible. Shoulder surgery is one area where arthroscopic technique is frequently used. It is used often when a shoulder has been dislocated, leaving the joint unstable. Unfortunately, the surgery isn't always successful over the long-term and the shoulder may dislocate again. In fact, with young adults, arthroscopic surgery doesn't have the same success rate that traditional, open, surgery has. Despite this, it's often the first choice because of the many advantages of arthroscopic surgery: quicker healing time, shorter hospital stay, and fewer complications.
The authors of this article wanted to identify risk factors that could contribute to the chances of redislocating the shoulder after arthroscopic surgery.
Researchers examined the progress of 385 patients (278 men) out of an original 422 at the start of the study. In 301 of the patients, it was their dominant shoulder that was affected. Ninety-two of the patients had experienced a first dislocation when they were 22 years old or younger, and there was an average of three months between injury and surgery for 97 patients, four to six months for 112 patients, seven to nine months for 95 patients and 10 to 12 months for the remaining 81. One hundred seventy six patients had experienced between one to three dislocations, 209 had four to six. After surgery, each patient received the same post-operative care and the same rehabilitation program. Follow up was done at three months, six months, one year, two years, and three years after surgery.
The researchers found that 31 patients (8.1 percent) had experienced another dislocation within three years of their surgery. Thirteen of these patients were those who had dislocated their shoulder their shoulder the first time before they were 22 years. The majority of those overall who redislocated were men (90.3 percent), and in 77.4 percent overall, it was their dominant shoulder.
The study authors concluded that it could be possible to identify patients who may be at higher risk of dislocating their shoulders again. However, they caution that their study was limited because it was retrospective (looked back) and did not have any protocols to be sure that all patients were on an equal basis. As well, they had no x-rays or other types of images that were taken after surgery to check if there was any damage that may only have been visible in that way.
Giuseppe Porcellini, MD, et al. Predisposing Factors for Recurrent Shoulder Dislocation After Arthroscopic Treatment. In Journal of Bone and Joint Surgery. No. 91. Pp. 2537 to 2542.