CORRELATION ANALYSIS BETWEEN RECURRENT ANTERIOR SHOULDER DISLOCATION AND SECONDARY INTRA-ARTICULAR INJURIES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Haifeng , LIU Yujie , LI Zhongli , LI Chunbao , DONG Xiaoyan , ZHU Juanli , LIU Yang.

Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China.;

Corresponding author：

Keywords：

Recurrent anterior shoulder dislocation; Secondary intra-articular injury; Correlation analysis

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【Abstract】 Objective To explore the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries through analyzing the correlation between the number of dislocation, disease duration, and the secondary intra-articular injuries. Methods The clinical data were analyzed retrospectively from 59 patients with recurrent anterior shoulder dislocation who underwent arthroscopic Bankart reconstruction using suture anchor between January 2005 and June 2009. There were 48 males and 11 females, and the average age was 27.6 years (range, 15-42 years). The causes of first dislocation included contact sports (21 cases), non-contact sports (13 cases), daily activities (11 cases), and trauma (14 cases). The average number of preoperative dislocations was 10.6 times (range, 3-32 times). The time between first dislocation and surgery was 11 months to 12 years (median, 5.9 years). The results of apprehension test and relocation test were positive in all patients. The University of California Los Angeles (UCLA) score was 22.3 ± 2.4, and Constant-Murley score was 73.1 ± 5.8 preoperatively. According to the arthroscopic findings, the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries was analyzed. Results All incisions healed by first intention, and no early complication occurred. All 59 patients were followed up 37.3 months on average (range, 16-58 months). At last follow-up, UCLA score was 34.6 ± 1.7 and Constant-Murley score was 86.7 ± 6.1, showing significant differences when compared with preoperative scores (P lt; 0.05). The number of preoperative dislocations was positively correlated with the severity of secondary articular cartilage injury (rs=0.345, P=0.007) and the severity of Hill-Sachs injury (rs=0.708, P=0.000). The time between first dislocation and surgery had a positive correlation with the severity of secondary articular cartilage injury (rs=0.498, P=0.000), but it had no correlation with the severity of Hill-Sachs injury (rs=0.021, P=0.874). Conclusion For patients with recurrent anterior shoulder dislocation, early Bankart reconstruction is benefit to functional recovery of shoulder and can avoid or delay the occurrence or development of secondary intra-articular injuries.

Citation： LI Haifeng,LIU Yujie,LI Zhongli,LI Chunbao,DONG Xiaoyan,ZHU Juanli,LIU Yang.. CORRELATION ANALYSIS BETWEEN RECURRENT ANTERIOR SHOULDER DISLOCATION AND SECONDARY INTRA-ARTICULAR INJURIES. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(3): 308-312. doi: Copy

1.	Hayes K, Callanan M, Walton J, et al. Shoulder instability: management and rehabilitation. J Orthop Sports Phys Ther, 2002, 32(10): 497-509.
2.	Deitch J, Mehlman CT, Foad SL, et al. Traumatic anterior shoulder dislocation in adolescents. Am J Sports Med, 2003, 31(5): 758-763.
3.	Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy, 2007, 23 (9): 985-990.
4.	Calandra JJ, Baker CL, Uribe J. The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthroscopy, 1989, 5(4): 254-257.
5.	Cameron ML, Kocher MS, Briggs KK, et al. The prevalence of glenohumeral osteoarthrosis in unstable shoulder. Am J Sports Med, 2003, 31(1): 53-55.
6.	Snyder SJ, Banas MP, Karzel RP, et al. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg, 1995, 4(4): 243-248.
7.	Brophy RH, Marx RG. The treatment of traumatic anterior instability of the shoulder: nonoperative and surgical treatment. Arthroscopy, 2009, 25(3): 298-304.
8.	Handoll HH, Almaiyah MA, Rangan A. Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev, 2004, (1): CD004325.
9.	朱献忠, 黄富国. 盂肱韧带维持肩关节前方稳定性生物力学研究. 中国修复重建外科杂志, 2007, 21(11): 1175-1178.
10.	Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med, 1997, 25(3): 306-311.
11.	Marx RG, McCarty EC, Montemurno TD, et al. Development of arthrosis following dislocation of the shoulder: a case-control study. J Shoulder Elbow Surg, 2002, 11(1): 1-5.
12.	Cheung EV, Sperling JW, Hattrup SJ, et al. Long-term outcome of anterior stabilization of the shoulder. J Shoulder Elbow Surg, 2008, 17(2): 265-270.
13.	Larrain MV, Montenegro HJ, Mauas DM, et al. Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique. Arthroscopy, 2006, 22(12): 1283-1289.
14.	Kim TK, Queale WS, Cosgarea AJ, et al. Clinical features of the different types of SLAP lesions: an analysis of one hundred and thirty-nine cases. J Bone Joint Surg (Am), 2003, 85-A(1): 66-71.
15.	Porcellini G, Paladini P, Campi F, et al. Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years. Arthroscopy, 2006, 22 (3): 270-276.
16.	刘玉杰, 周密, 李光辉, 等. 肩关节脱位合并肩袖与Bankart损伤的诊治. 中华创伤骨科杂志, 2008, 10(10): 915-918.
17.	Law BK, Yung PS, Ho EP, et al. The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc, 2008, 16 (2): 188-193.

1. Hayes K, Callanan M, Walton J, et al. Shoulder instability: management and rehabilitation. J Orthop Sports Phys Ther, 2002, 32(10): 497-509.
2. Deitch J, Mehlman CT, Foad SL, et al. Traumatic anterior shoulder dislocation in adolescents. Am J Sports Med, 2003, 31(5): 758-763.
3. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy, 2007, 23 (9): 985-990.
4. Calandra JJ, Baker CL, Uribe J. The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthroscopy, 1989, 5(4): 254-257.
5. Cameron ML, Kocher MS, Briggs KK, et al. The prevalence of glenohumeral osteoarthrosis in unstable shoulder. Am J Sports Med, 2003, 31(1): 53-55.
6. Snyder SJ, Banas MP, Karzel RP, et al. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg, 1995, 4(4): 243-248.
7. Brophy RH, Marx RG. The treatment of traumatic anterior instability of the shoulder: nonoperative and surgical treatment. Arthroscopy, 2009, 25(3): 298-304.
8. Handoll HH, Almaiyah MA, Rangan A. Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev, 2004, (1): CD004325.
9. 朱献忠, 黄富国. 盂肱韧带维持肩关节前方稳定性生物力学研究. 中国修复重建外科杂志, 2007, 21(11): 1175-1178.
10. Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med, 1997, 25(3): 306-311.
11. Marx RG, McCarty EC, Montemurno TD, et al. Development of arthrosis following dislocation of the shoulder: a case-control study. J Shoulder Elbow Surg, 2002, 11(1): 1-5.
12. Cheung EV, Sperling JW, Hattrup SJ, et al. Long-term outcome of anterior stabilization of the shoulder. J Shoulder Elbow Surg, 2008, 17(2): 265-270.
13. Larrain MV, Montenegro HJ, Mauas DM, et al. Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique. Arthroscopy, 2006, 22(12): 1283-1289.
14. Kim TK, Queale WS, Cosgarea AJ, et al. Clinical features of the different types of SLAP lesions: an analysis of one hundred and thirty-nine cases. J Bone Joint Surg (Am), 2003, 85-A(1): 66-71.
15. Porcellini G, Paladini P, Campi F, et al. Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years. Arthroscopy, 2006, 22 (3): 270-276.
16. 刘玉杰, 周密, 李光辉, 等. 肩关节脱位合并肩袖与Bankart损伤的诊治. 中华创伤骨科杂志, 2008, 10(10): 915-918.
17. Law BK, Yung PS, Ho EP, et al. The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc, 2008, 16 (2): 188-193.

Chinese Journal of Reparative and Reconstructive Surgery

CORRELATION ANALYSIS BETWEEN RECURRENT ANTERIOR SHOULDER DISLOCATION AND SECONDARY INTRA-ARTICULAR INJURIES

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