Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation
Olds, M. K., Ellis, R., Parmar, P. and Kersten, P. 2019. Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation. BMJ Open Sport and Exercise Medicine. 5 (1). https://doi.org/10.1136/bmjsem-2018-000447
|Authors||Olds, M. K., Ellis, R., Parmar, P. and Kersten, P.|
To develop a multivariate tool that would predict recurrent instability after a first-time traumatic anterior shoulder dislocation.
Participants (aged 16–40 years) were recruited across New Zealand into a prospective cohort study. Baseline data were collected during a telephone interview and through examination of radiology records. Variables associated with recurrent instability were selected for the multivariate logistic regression model using backwards selection (p<0.10). Coefficients for those variables retained in the model were used to develop the predictive tool.
Among the 128 participants, 36% had redislocated at least once in the first 12 months. Univariate analysis showed an increased likelihood of recurrent dislocation with bony Bankart lesions (OR=3.65, 95% CI 1.05 to 12.70, p=0.04) and participants who had: not been immobilised in a sling (OR = 0.38, 95% CI 0.15 to 0.98, p=0.05), higher levels of shoulder activity (OR=1.13, 95% CI 1.01 to 1.27, p=0.03), higher levels of pain and disability (OR=1.03, 95% CI 1.01 to 1.06, p=0.02), higher levels of fear of reinjury (OR=1.12, 95% CI 1.01 to 1.26, p=0.04) and decreased quality of life (OR=1.01, 95% CI 1.00 to 1.02, p=0.05). There was no significant difference in those with non-dominant compared with dominant shoulder dislocations (p=0.10) or in those aged 16–25 years compared with 26–40 years (p=0.07).
Six of seven physical and psychosocial factors can be used to predict recurrent shoulder instability following a first-time traumatic anterior shoulder dislocation.
|Keywords||Shoulder dislocation; Redislocation; Recurrent instability|
|Journal||BMJ Open Sport and Exercise Medicine|
|Journal citation||5 (1)|
|Publisher||BMJ Publishing Group|
|Digital Object Identifier (DOI)||https://doi.org/10.1136/bmjsem-2018-000447|
|Online||07 Mar 2019|
|Publication process dates|
|Accepted||10 Feb 2019|
|Deposited||14 Apr 2022|
|Accepted author manuscript|
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