Shoulder Instability

Shoulder Instability comprises a broad spectrum of complaints from recurrent dislocations to intermittent subluxations (partial dislocations). Subluxations actually comprise 85% of instability and have been shown to result in labral tears (Bankart lesion). Young athletes with first-time shoulder instability injuries should consider surgical stabilization, and older patients with chronic instability that limits their lifestyle may also choose to undergo stabilization. Patients with bone loss may not be candidates for arthroscopic stabilization and may require open bone augmentation procedures.

RELATED STUDIES

SHOULDER SUBLUXATIONS COMPRISE 85% OF ALL TRAUMATIC SHOULDER INSTABILITY EVENTS

This prospective study of shoulder instability in the closed population of West Point cadets reports the highest known incidence rates in the world. Anterior events comprised 90%, and subluxations were 85% of all events.

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SHOULDER SUBLUXATIONS RESULT IN BANKART LESIONS

This prospective study of first-time shoulder subluxation patients undergoing early MRI, showed that most had sustained a Bankart lesion – tearing of the anterioinferior glenoid labrum.

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HISTORY IS BIGGEST PREDICTOR OF SUBSEQUENT SHOULDER INSTABILITY

Prospective 4 year study of high-risk young athletes showed that history of prior instability event was the greatest predictor of sustaining a shoulder dislocation or subluxation event.

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ROTATOR CUFF WEAKNESS IS NOT A RISK FACTOR FOR ANTERIOR INSTABILITY

Prospective cohort study with baseline strength assessment clarifies issue of rotator cuff weakness seen in shoulder instability patients. The weakness may result from instability episodes but is not a risk factor for initial injury.

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INCREASED GLENOID RETROVERSION IS RISK FACTOR FOR POSTERIOR INSTABILITY

Prospective cohort studies showed that for every 1 degree increase in glenoid retroversion, there was a 17% increased risk of posterior instability in young athletes.

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PEDIATRIC SHOULDER DISLOCATIONS

Review article on pediatric shoulder dislocations presented pooled results from the literature. This work suggests that patients with open growth plates and are younger than 14 are often treated successfully without surgery. Patients older than 14 often experience recurrent instability and should be treated similarly to young adults.

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YOUNG AGE ASSOCIATED WITH HIGHER FAILURE RATE OF INSTABILITY REPAIR

Retrospective review of 3,854 patients undergoing surgical stabilization. Younger age and open repair were associated with increased failure rate.

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IN-SEASON SHOULDER INSTABILITY IN ATHLETES

Prospective multicenter cohort study followed collegiate collision athletes following a traumatic anterior shoulder instability event and found that only 27% returned to sport successfully without sustaining a recurrent event.

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•  Rotator Cuff Tear

•  Subacromial Impingement

•  SLAP Lesion/Biceps Tendinopathy

•  Acromioclavicular (A-C) Sprain/Shoulder Separation

•  Pectoralis Major Tendon Tear

•  Clavicle Fracture

•  Snapping Scapula Syndrome

CONTACT

Dr. Brett D. Owens

100 Butler Drive

Providence, RI 02906

Phone: 401-330-1434

Fax: 401-277-0799

TEAM LINKS

www.goarmysports.com

www.brownbears.com

www.uslacrosse.org

DISCLAIMER

All information contained on the BrettOwensmd.com website is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.