Risk Factors Which Predispose First-time Traumatic Anterior Shoulder Dislocations to Recurrent Instability in Adults: A Systematic Review and Meta-analysis
Date
Authors
Olds, M
Ellis, R
Donaldson, K
Parmar, P
Kersten, P
Supervisor
Item type
Journal Article
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Journal Title
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Volume Title
Publisher
BMJ Publishing
Abstract
Background: Recurrent instability following a first-time anterior traumatic shoulder dislocation may exceed 26%. We systematically reviewed risk factors which predispose this population to events of recurrence. Methods: A systematic review of studies published before 1 July 2014. Risk factors which predispose recurrence following a first-time traumatic anterior shoulder dislocation were documented and rates of recurrence were compared. Pooled ORs were analysed using random-effects meta-analysis. Results: Ten studies comprising 1324 participants met the criteria for inclusion. Recurrent instability following a first-time traumatic anterior shoulder dislocation was 39%. Increased risk of recurrent instability was reported in people aged 40 years and under (OR=13.46), in men (OR=3.18) and in people with hyperlaxity (OR=2.68). Decreased risk of recurrent instability was reported in people with a greater tuberosity fracture (OR=0.13). The rate of recurrent instability decreased as time from the initial dislocation increased. Other factors such as a bony Bankart lesion, nerve palsy and occupation influenced rates of recurrent instability. Conclusions: Sex, age at initial dislocation, time from initial dislocation, hyperlaxity and greater tuberosity fractures were key risk factors in at least two good quality cohort studies resulting in strong evidence as concluded in the GRADE criteria. Although bony Bankart lesions, Hill Sachs lesions, occupation, physiotherapy treatment and nerve palsy were risk factors for recurrent instability, the evidence was weak using the GRADE criteria—these findings relied on poorer quality studies or were inconsistent among studies.Description
Keywords
Epidemiology, Meta-analysis, Recurrent, Risk factor, Shoulder, Recurrence, Shoulder instability, First time, Anterior shoulder dislocation, Risk factors
Source
British Journal of Sports Medicine. 2015;49:911-912. doi:10.1136/bjsports-2015-094584
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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/