Less than 60% return to preinjury sports activities after primary anterior shoulder dislocation treated with immobilisation only

Abstract

BackgroundShoulder dislocation is a common injury among young athletes, especially those who play contact sports.ObjectiveThe aim of this systematic review is to investigate the return to preinjury sporting activities in patients who have undergone a conservative treatment with immobilisation after a primary anterior shoulder dislocation.Data sourcesWe conducted electronic searches without restriction of language on the EMBASE and PUBMED databases, using the term ‘shoulder dislocation’ for each database.Study selectionAll prospective studies that have evaluated the role of immobilisation for first-time shoulder dislocation were included in this review.Synthesis methods and risk of biasAuthor's name, year of publication, design of study, population, sample size, follow-up times, immobilisation method, and the rate of patients' return to preinjury sporting activities were extracted from the selected articles. The instrument used for assessing the risk of bias of the included articles was the PEDro scale.ResultsA total of 7397 studies were found. From the four studies included in this review four of them used external rotation (ER) as treatment for three weeks. A total of 214 participants were recruited for ER and 169 for internal rotation (IR). On average, 58.9% (95% CI 51.1% to 64.7%) for immobilisation in ER and 42.6% (95% CI 34.5% to 49.8%) for immobilisation in IR returned to preinjury sports activities. PEDro scores for the included studies ranged from 3 to 6.ConclusionsOn the basis of the best available evidence that the studies reported, on average <60% return to preinjury sports activity level.