Intra-articular lesions and their relation to arthroscopic stabilization failure in young patients with first-time and recurrent shoulder dislocations.
BACKGROUND
This study aimed to compare the frequency of intra-articular lesions between young patients with first-time shoulder dislocations and those with recurrent shoulder dislocations and to assess the correlation between intra-articular lesions and failure of arthroscopic stabilization.


METHODS
The study enrolled 33 patients who underwent arthroscopic Bankart repair after first-time shoulder dislocation before the age of 30 years. There were 89 age-matched patients who were treated arthroscopically for recurrent dislocation included as a control group.


RESULTS
Among intra-articular pathologic findings, anterior glenoid erosion (P = .043) and anterior labral periosteal sleeve avulsion lesions (P = .048) were found more frequently in the recurrent dislocation group. There was no statistically significant difference between the 2 groups in American Shoulder and Elbow Surgeons (P = .675) and Rowe (P = .132) scores at the last follow-up. However, there was a significant difference in the failure rate after operation between the 2 groups (P = .039). In the first-time dislocation group, 1 patient had redislocation and none showed positive apprehension. In the recurrent dislocation group, 6 patients had redislocation and 10 patients had positive apprehension. Eight of 10 patients who showed positive apprehension had either anterior labral periosteal sleeve avulsion lesions or anterior glenoid erosion. The patients' satisfaction with daily activities was significantly better in the first-time dislocation group (93.0 ± 5.2) than in the recurrent dislocation group (82.7 ± 7.2; P < .001).


CONCLUSIONS
Primary surgical treatment for first-time traumatic anterior shoulder dislocation provided satisfactory functional outcomes and improved quality of life. Primary arthroscopic stabilization can be considered one of the treatment options in patients younger than 30 years with first-time shoulder dislocation to prevent further intra-articular injuries that may contribute to recurrence.
Ewha Shoulder Disease Center, Department of Orthopaedic Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. Electronic address: sjshin622@ewha.ac.kr.
Sang-Jin
SJ
Shin
Ewha Shoulder Disease Center, Department of Orthopaedic Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Young Won
YW
Ko
Ewha Shoulder Disease Center, Department of Orthopaedic Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Juyeob
J
Lee
D000328:Adult; D001182:Arthroscopy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012008:Recurrence; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000473:pathology*; D055815:Young Adult
ALPSA lesion; Anterior shoulder dislocation; arthroscopic stabilization procedure; first-time shoulder dislocation; glenoid erosion; recurrent shoulder dislocation