Recurrence rates and factors affecting recurrence after traumatic anterior shoulder dislocation

Abstract

Objective: To investigate the factors affecting the recurrence of anterior shoulder dislocation, identify the patient group with the highest recurrence rate for shoulder dislocation, and determine the patient population to be recommended surgical treatment after primary dislocation.
 Material and Methods: Patients diagnosed with primary shoulder dislocation and treated in our hospital between January 2005 and January 2017 were retrospectively screened. Of the 1395 patients identified, 1253 were reached by phone to obtain follow-up information. Patients whose follow-up information was not available, those with posterior dislocations, multidirectional instabilities, general joint hypermobility, traumatic nerve injury or shoulder fracture-dislocations (including greater tuberosity and glenoid fractures), and those that had undergone surgical treatment after primary dislocation were excluded from the study. The general joint laxity of the patients was evaluated using the Beighton scale. Patients with traumatic primary anterior shoulder dislocation and at least two years of follow-up data were included in the study and divided into three age groups as under 20, 20 to 40, over 40. 
 Results: After applying the exclusion and inclusion criteria, 1,004 patients were included in the study. Recurrence was detected in 408 of these patients (40.6%). The highest recurrence rate was in the under 20 years old group at 52% (88/170). The recurrence rate was determined as 43% (283/659) for the 20-40 years group and 21% (37/175) for the over 40 group. It was determined that except for age, gender and presence of bone defects (Hill-Sachs lesion), the remaining parameters, namely immobilization time, injury mechanism, presence and type of sports activity, dominant-side dislocation, and smoking had no significant effect on the risk of recurrence after primary dislocation.
 Conclusion: In conclusion, the surgical treatment option should be presented to young male patients with bone defects after primary dislocation and they should be informed about the possible problems due to recurrent instability.