Competitive sports and accidents may result in shoulder dislocation injuries for some individuals. This type of injury is treated through rehabilitation, immobility, and sometimes surgery. Shoulder dislocations can be debilitating, uncomfortable and painful. Dr. Grossfeld has some of the latest research on shoulder dislocations to help you better understand this injury and further complications.
The researchers evaluated 100 patients who had undergone shoulder dislocations and subsequently underwent a Bankart reconstruction. A Bankart reconstruction is used to repair the capsule and labrum that gets torn in a shoulder dislocation. The researchers were interested in the amount of recurrent dislocations that occurred after surgery. They also wanted to know the percentage of patients that then developed osteoarthritis and the severity of the osteoarthritis.
It is a well-known fact that once you have had a shoulder dislocation, your shoulder is at risk for two future problems: 1) Recurrent dislocation and, 2) The development of osteoarthritis within the shoulder joint. The trauma sustained at the time of the dislocation can damage the cartilage that involved the shoulder joint which can result in early onset osteoarthritis involving the shoulder.
There is scientific documentation that after shoulder dislocations, arthritis can occur. A study completed in Munich, Germany, specifically looked at how many shoulder dislocation patients developed osteoarthritis post-injury.
This research was published in the American Journal of Sports Medicine in May, 2015 by Dr. Plath. The researchers included 100 patients that were available for evaluation. They found that 31 percent of the patients show no evidence of osteoarthritis in the shoulder joint at 10 years of follow up. Twenty-one percent of the patients sustained a recurrent dislocation even after undergoing a shoulder stabilization procedure, and 31 percent of the shoulder showed no evidence of glenohumeral joint arthritis.
The researchers divided up the patients that had osteoarthritis after the shoulder dislocation and after undergoing surgery. They found that 41 percent of the patients had mild osteoarthritis, 16 percent had moderate osteoarthritis, and 12 percent had severe osteoarthritic changes.
In conclusion, the researchers stated that on average, 13 years after arthroscopic Bankart repair, osteoarthritic changes were a common finding. They noted that the age of the patient seemed more relevant for long term dislocation arthropathy than the treatment. They felt that avoiding preoperative dislocations is more important for the prevention of osteoarthritis than short term treatment.
Older age and initial dislocation and surgery appear to be a particular shoulder osteoarthritis development. In fact, age at the time of surgery is the most consistent risk factor in the literature to date. The findings related to the normal aging process found that older patients have a higher incidence of arthritis than younger patients; however, primarily shoulder arthritis is a rare condition, and given the strong correlation of osteoarthritis and age within the study, it is evident that an older joint is more susceptible to damage at the time of the shoulder dislocation.
We also know that if you are over age 60 and you have a shoulder dislocation, 80 percent of the time there is a full thickness rotator cuff tear that occurs secondary to the injury.
The number of dislocations before Bankart repair correlated with the grade of the dislocation osteoarthritis. This implies that regardless of surgery, the extent of the trauma likely decides the fate of the long-term joint injury/degeneration.
If you have suffered a shoulder dislocation in the past and are suffering from osteoarthritis, we can help. Call Dr. Stacie Grossfeld at 502-212-2663 today or visit Orthopaedic Specialists in Louisville, KY to seek medical care.