title: The pathology of the anterior capsule in patients over forty years of age with recurrent shoulder dislocation.
abstract: OBJECTIVE
  We evaluated the pathologies of anterior capsular mechanism in older patients with recurrent anterior shoulder dislocation in the absence of full-thickness rotator cuff tears.
  
  
  METHODS
  Three hundred and ninety-five shoulders with recurrent anterior shoulder dislocation were assessed. The patients were divided into three groups by the age at the first dislocation and the surgical treatment: group A (onset and treatment were at an age over 40 years), group B (onset was at an age under 40 years and treatment was at an age over 40 years) and group C (onset and treatment were at an age under 40 years). Groups A, B and C involved nine, 31 and 355 shoulders, respectively.
  
  
  RESULTS
  The prevalence of an isolated Bankart lesion was 81.7 % in group C, 33.3 % in group A and 64.5 % in group B, and each of A and B was significantly lower than group C. The prevalence of an isolated capsular tear was 3.1 % in group C, while it was 33.3 % in group A, which was significantly higher.
  
  
  CONCLUSIONS
  The prevalence of an isolated Bankart lesion was low and the prevalence of a capsular tear was high in older patients. We should keep in mind the existence of a capsular tear in older patients and examine the whole anterior capsular mechanism meticulously.
authors.affiliation: Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka-shi, 560-8565, Osaka, Japan. nao-miz@hcc5.bai.ne.jp.
authors.forename: Naoko
authors.initials: N
authors.lastname: Mizuno
authors.affiliation: Arthroscopy and Sports Medicine Center, Nakanoshima Iwaki Hospital, 3-2-9 Fukushima, Fukushima-ku, Osaka-shi, 553-0003, Osaka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoneda
authors.affiliation: Department of Sports Orthopaedic Surgery, Yukioka Hospital, 2-2-3 Ukita, Kita-ku, Osaka-shi, 530-0021, Osaka, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Department of Orthopaedic Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka-shi, 543-0035, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hayashida
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000473:pathology*; D007593:Joint Instability / Q000601:surgery; D022125:Lacerations; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012783:Shoulder Dislocation / Q000473:pathology* / Q000601:surgery; D012785:Shoulder Joint / Q000473:pathology*; D055815:Young Adult
keywords: Anterior capsular mechanism; Arthroscopy; Capsular tear; Patients over 40 years of age; Recurrent anterior shoulder dislocation