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Meta-Analysis
. 2024 Oct 1;106-B(10):1141-1149.
doi: 10.1302/0301-620X.106B10.BJJ-2024-0396.R1.

Outcomes of arthroscopic stabilization for recurrent instability are equal to stabilization after a primary event

Jawaad Saleem  1 , Ben Rawi  1 , Magnus Arnander  1 , Eyiyemi Pearse  1 , Duncan Tennent  1
Affiliations
Meta-Analysis

Outcomes of arthroscopic stabilization for recurrent instability are equal to stabilization after a primary event

Jawaad Saleem et al. Bone Joint J. .

Abstract

Aims: Extensive literature exists relating to the management of shoulder instability, with a more recent focus on glenoid and humeral bone loss. However, the optimal timing for surgery following a dislocation remains unclear. There is concern that recurrent dislocations may worsen subsequent surgical outcomes, with some advocating stabilization after the first dislocation. The aim of this study was to determine if the recurrence of instability following arthroscopic stabilization in patients without significant glenoid bone loss was influenced by the number of dislocations prior to surgery.

Methods: A systematic review and meta-analysis was performed using the PubMed, EMBASE, Orthosearch, and Cochrane databases with the following search terms: ((shoulder or glenohumeral) and (dislocation or subluxation) and arthroscopic and (Bankart or stabilisation or stabilization) and (redislocation or re-dislocation or recurrence or instability)). Methodology followed the PRISMA guidelines. Data and outcomes were synthesized by two independent reviewers, and papers were assessed for bias and quality.

Results: Overall, 35 studies including 7,995 shoulders were eligible for analysis, with a mean follow-up of 32.7 months (12 to 159.5). The rate of post-stabilization instability was 9.8% in first-time dislocators, 9.1% in recurrent dislocators, and 8.5% in a mixed cohort. A descriptive analysis investigated the influence of recurrent instability or age in the risk of instability post-stabilization, with an association seen with increasing age and a reduced risk of recurrence post-stabilization.

Conclusion: Using modern arthroscopic techniques, patients sustaining an anterior shoulder dislocation without glenoid bone loss can expect a low risk of recurrence postoperatively, and no significant difference was found between first-time and recurrent dislocators. Furthermore, high-risk cohorts can expect a low, albeit slightly higher, rate of redislocation. With the findings of this study, patients and clinicians can be more informed as to the likely outcomes of arthroscopic stabilization within this patient subset.

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Conflict of interest statement

D. Tennent reports royalties or licenses, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, patents planned, issued or pending from Arthrex, unrelated to this study, and is a member of the editorial board of The Bone & Joint Journal.

References

    1. Zacchilli MA , Owens BD . Epidemiology of shoulder dislocations presenting to emergency departments in the United States . J Bone Joint Surg Am . 2010 ; 92-A ( 3 ): 542 – 549 . 10.2106/JBJS.I.00450 20194311
    1. Cutts S , Prempeh M , Drew S . Anterior shoulder dislocation . Ann R Coll Surg Engl . 2009 ; 91 ( 1 ): 2 – 7 . 10.1308/003588409X359123 19126329
    1. Hurley ET , Manjunath AK , Bloom DA , et al. Arthroscopic Bankart repair versus conservative management for first-time traumatic anterior shoulder instability: a systematic review and meta-analysis . Arthroscopy . 2020 ; 36 ( 9 ): 2526 – 2532 . 10.1016/j.arthro.2020.04.046 32389771
    1. Grumet RC , Bach BR , Provencher MT . Arthroscopic stabilization for first-time versus recurrent shoulder instability . Arthroscopy . 2010 ; 26 ( 2 ): 239 – 248 . 10.1016/j.arthro.2009.06.006 20141987
    1. Barlow JD , Grosel T , Higgins J , Everhart JS , Magnussen RA . Surgical treatment outcomes after primary vs recurrent anterior shoulder instability . J Clin Orthop Trauma . 2019 ; 10 ( 2 ): 222 – 230 . 10.1016/j.jcot.2018.10.012 30828182