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Predisposing Factors for Recurrent Shoulder Dislocation After Arthroscopic Treatment
Giuseppe Porcellini, MD1; Fabrizio Campi, MD1; Francesco Pegreffi, MD1; Alessandro Castagna, MD2; Paolo Paladini, MD1
1 Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via LV Beethoven 1, 47841 Cattolica (RN), Italy. E-mail address for G. Porcellini: chirurgiaspalla@virgilio.it
2 IRCCS Istituto Clinico Humanitas–Rozzano, Via Manzoni 56, 20089 Rozzano (MI), Italy
View Disclosures and Other Information
A commentary by Brett D. Owens, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Cattolica, Italy

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Nov 01;91(11):2537-2542. doi: 10.2106/JBJS.H.01126
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Background: Arthroscopic repair of anterior dislocation of the shoulder can fail. We hypothesized that patients who are at higher risk for redislocation following repair could be recognized preoperatively on the basis of their clinical history. The purpose of the present study was to identify the risk factors for recurrence in a community-based population of patients with traumatic unidirectional instability that was treated with a single arthroscopic technique.

Methods: From January 2000 to December 2003, 625 patients with anterior unidirectional instability were managed with an arthroscopic Bankart technique, and 385 met the criteria for inclusion in the study. Demographic data were collected, and clinical follow-up was performed at three, six, twelve, twenty-four, and thirty-six months.

Results: At thirty-six months, thirty-one patients (8.1%) had experienced a redislocation; the rate was 13.3% among patients who were twenty-two years of age and younger and 6.3% among older patients. Age at the time of the first dislocation, male sex, and the time from the first dislocation until surgery were significant risk factors for recurrence (p < 0.05 for all).

Conclusions: Patients who are more likely to have a redislocation following arthroscopic repair of an anterior shoulder dislocation can be identified preoperatively on the basis of sex, age, and the time from the first dislocation to surgery.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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