Shoulder Re-Dislocation Rate Studied Over Time

May 9, 2008

Patients aged 12 to 25 who receive non-operative treatment for a primary anterior shoulder dislocation have about a 50 percent chance of their shoulder becoming stable over time or not having a recurrent dislocation, according to a report published in the May issue of the Journal of Bone & Joint Surgery.

FRIDAY, May 9 (HealthDay News) -- Patients aged 12 to 25 who receive non-operative treatment for a primary anterior shoulder dislocation have about a 50 percent chance of their shoulder becoming stable over time or not having a recurrent dislocation, according to a report published in the May issue of the Journal of Bone & Joint Surgery.

During 1978 and 1979, Lennart Hovelius, M.D., Ph.D., of Gavle Hospital in Gavle, Sweden, and colleagues started a prospective study of 255 patients aged 12 to 40 who underwent non-operative treatment on 257 shoulders. After 25 years, all 227 surviving patients (229 shoulders) completed the follow-up questionnaire, and 214 of them completed the Disabilities of the Arm, Shoulder and Hand questionnaire.

The researchers identified no recurrences in 28 percent of the shoulders in patients who were aged 12 to 22 at the time of the primary dislocation and 44 percent of the shoulders in patients who were aged 23 to 29. After excluding shoulders with a fracture of the greater tuberosity, they also found that 19 percent of the total number of shoulders and 29 percent of the recurrent or surgically stabilized shoulders had become stable in patients who were 29 years of age or younger at the time of the primary dislocation.

"The present study demonstrates that the prognosis for the younger ages is neither very good nor very bad," the authors write. "On the basis of these findings, it is our opinion that routine, immediate surgery for the treatment of all first-time dislocations in patients 25 years of age or younger will result in a rate of unnecessary operations of at least 30 percent, or possibly 50 percent, if one considers the number of shoulders that became stable over time."

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