title: Predictors of functional outcomes and recurrent shoulder instability after arthroscopic anterior stabilization.
abstract: OBJECTIVE
  To investigate what factors might predict the results of arthroscopic stabilization for anterior shoulder instability.
  
  
  METHODS
  One hundred and forty-three patients averaging 25 (15-58) years with traumatic anterior shoulder instability who underwent arthroscopic stabilization were reviewed at a median follow-up of 81 (24-172) months. Sixty-two (56.4 %) individuals were involved in contact sport activities, and there were 40 (30 %) patients who had only one dislocation prior to having surgery. Rowe score was measured preoperatively and at follow-up.
  
  
  RESULTS
  Thirty-three (23.1 %) patients experienced recurrent instability 12 (1-120) months after surgery, and 15 of those underwent further surgery. There was a statistically significant lower risk of failure (p = 0.027) for patients who had a surgical procedure after only one episode of shoulder dislocation. Patients treated after the second or further episode of shoulder dislocation exhibited a mean odds ratio for failure of 3.8 (95 % confidence interval 1.2-11.6, p = 0.044) with regard to first-time dislocators. The Rowe score significantly improved from a preoperative value of 25 (5-55) to a postoperative value of 100 (40-100) (p < 0.001). A significantly higher postoperative Rowe score was found in patients older than 24 years of age at the operation (p = 0.011) and in patients with less than eight dislocations prior to surgery (p = 0.05).
  
  
  CONCLUSIONS
  These results suggest that better functional results following arthroscopic stabilization can be expected in patients over 24 years of age and in those with a fewer number of dislocations preoperatively. A lower rate of recurrence can be expected if the patient undergoes surgery after the first episode of dislocation.
  
  
  METHODS
  Prognostic study, Level II.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Mater Domini University Hospital, Viale Europa, 88100, Catanzaro, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Benedetto
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Mater Domini University Hospital, Viale Europa, 88100, Catanzaro, Italy.
authors.forename: Arcangela
authors.initials: A
authors.lastname: Cundari
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Mater Domini University Hospital, Viale Europa, 88100, Catanzaro, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: De Gori
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orlando
authors.affiliation: Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Edward G
authors.initials: EG
authors.lastname: McFarland
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Mater Domini University Hospital, Viale Europa, 88100, Catanzaro, Italy. galasso@unicz.it.
authors.forename: Olimpio
authors.initials: O
authors.lastname: Galasso
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castricini
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroscopic stabilization; First-time dislocators; Outcome predictors; Shoulder instability