Abstract
In the young athlete, anterior shoulder dislocations are common injuries that usually result in recurrent instability, and often require surgical treatment. Nonoperative treatment remains the initial recommended course for most conditions. Operative treatment has advanced to more anatomical repairs, both open and arthroscopic. The purpose of this paper is to review the evaluation and treatment of anterior shoulder instability, to include acute dislocations, acute subluxations and recurrent instability.
Similar content being viewed by others
References
Rokous JR, Feagin JA, Abbott HG. Modified axillary roentgenogram. Clin Orthop 1972; 82: 84–6
Flatow E, Miller S, Neer C. Chronic anterior dislocations of the shoulder. J Shoulder Elbow Surg 1993; 2: 2–10
Russell JA, Holmes 3rd EM, Keller DJ, et al. Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries. J Trauma 1981; 21 (9): 802–4
Suder PA, Mikkelsen JB, Hougaard K, et al. Reduction of traumatic secondary shoulder dislocations with lidocaine. Arch Orthop Trauma Surg 1995; 14: 233–6
Arciero RA, Wheeler JH, Ryan JB, et al. Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med 1994; 127: 589–94
Tsai L, Wredmark T, Johansson C, et al. Shoulder function in patients with unoperated anterior shoulder instability. Am J Sports Med 1991; 11: 469–73
Marans HJ, Angel KR, Schemitsch EH, et al. The fate of traumatic anterior dislocation of the shoulder in children. J Bone Joint Surg Am 1992; 77: 1242–4
Hoelen MA, Burgers AM, Rozing PM. Prognosis of primary anterior shoulder dislocation in young adults. Arch Orthop Trauma Surg 1990; 31: 51–4
Ryf C, Matter P. The initial traumatic shoulder dislocation: prospective study [in German]. Z Unfallchir Versicherungsmed 1993; 22: 204–12
Hovelius L, Augustini BG, Fredin H, et al. Primary anterior dislocation of the shoulder in young patients: a ten-year prospective study. J Bone Joint Surg Am 1996; 41: 1677–84
Elbaum R, Parent H, Zeller R, et al. Traumatic scapulo-humeral dislocation in children and adolescents: apropos of 9 patients [in French]. Acta Orthop Belg 1994; 60: 204–9
Itoi E, Newman SR, Kuechle DK, et al. Dynamic anterior stabilisers of the shoulder with the armin abduction. J Bone Joint Surg Br 1994; 14: 834–6
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; 16: 306–11
Norlin R. Intraarticular pathology in acute, first-time anterior shoulder dislocation: an arthroscopic study. Arthroscopy 1993; 114: 546–9
Benedetto KP, Glotzer W. Arthroscopic Bankart procedure by suture technique: indications, technique, and results. Arthroscopy 1992; 9: 111–5
Jerosch J, Drescher H, Steinbeck J, et al. Current concepts in treatment of the unstable shoulder: results of a countrywide survey [in German]. Unfallchirurg 1994; 97: 64–8
Arciero RA, DeBerardino TM. Acute and chronic dislocations of the shoulder. In: Norris TR, editor. Orthopaedic knowledge update: shoulder and elbow. 1st ed. Rosemont (IL): American Academy of Orthopaedic Surgeons, 1997: 67–76
Arciero RA. Acute traumatic anterior dislocation of the shoulder. In: Bigliani LU, editor. The unstable shoulder. 1st ed. Rosemont (IL): American Academy of Orthopaedic Surgeons, 1996: 37–46
Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle: clinical features in 16 cases. J Bone Joint Surg Br 1991; 78: 389–94
Lill H, Lange K, Reinbold WD, et al. MRI arthrography: improved diagnosis of shoulder joint instability [in German]. Unfallchirurg 1997; 100: 186–92
Hawkins RJ, Bokor DJ. Clinical evaluation of shoulder problems. In: Rockwood CA, Matsen FA, editors. The shoulder. 1st ed. Philadelphia: W.B. Saunders, 1990: 149–77
Wolf EM, Cheng JC, Dickson K. Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability. Arthroscopy 1995; 11: 600–7
Jobe C. Superior glenoid impingement. Clin Orthop 1996; 330: 98–107
Levine WN, Richmond JC, Donaldson WR. Use of the suture anchor in open Bankart reconstruction: a follow-up report. Am J Sports Med 1994; 57: 723–6
Gill TJ, Micheli LJ, Gebhard F, et al. Bankart repair for anterior instability of the shoulder: long-term outcome. J Bone Joint Surg Am 1997; 100: 850–7
Fredriksson AS, Tegner Y. Results of the Putti-Platt operation for recurrent anterior dislocation of the shoulder. Int Orthop 1991; 20: 185–8
Konig DP, Rutt J, Treml O, et al. Osteoarthritis and recurrences after Putti-Platt and Eden-Hybbinette operations for recurrent dislocation of the shoulder. Int Orthop 1997; 6: 72–6
MacDonald PB, Hawkins RJ, Fowler PJ, et al. Release of the subscapularis for internal rotation contracture and pain after anterior repair for recurrent anterior dislocation of the shoulder. J Bone Joint Surg Am 1992; 32: 734–7
Hawkins RJ, Angelo RL. Glenohumeral osteoarthrosis: a late complication of the Putti-Platt repair. J Bone Joint Surg Am 1990; 72: 1193–7
Konig DP, Rutt J, Treml O, et al. Osteoarthrosis following the Putti-Platt operation. Arch Orthop Trauma Surg 1996; 11: 231–2
Allen AA, Warner JJ. Shoulder instability in the athlete. Orthop Clin North Am 1995; 21: 487–504
Wirth MA, Blatter G, Rockwood Jr CA. The capsular imbrication procedure for recurrent anterior instability of the shoulder. J Bone Joint Surg Am 1996; 26: 246–59
Montgomery WI, Jobe F. Functional outcomes in athletes after modified anterior capsulolabral reconstruction. Am J Sports Med 1994; 22: 352–8
Mologne TS, Lapoint JM, Morin WD, et al. Arthroscopic anterior labral reconstruction using a transglenoid suture technique: results in active-duty military patients. Am J Sports Med 1996; 8: 268–74
Walch G, Boileau P, Levigne C, et al. Arthroscopic stabilization for recurrent anterior shoulder dislocation: results of 59 cases. Arthroscopy 1995; 14: 173–9
Green MR, Christensen KP. Arthroscopic Bankart procedure: two- to five-year followup with clinical correlation to severity of glenoid labral lesion. Am J Sports Med 1995; 24: 276–81
Yoneda M, Hayashida K, Izawa K, et al. A simple and secure anchoring system for Caspari’s transglenoid multiple suture technique using a biodegradable poly-l-lactic acid button. Arthroscopy 1996; 78: 293–9
Youssef JA, Carr CF, Walther CE, et al. Arthroscopic Bankart suture repair for recurrent traumatic unidirectional anterior shoulder dislocations. Arthroscopy 1995; 21: 561–3
Grana WA, Buckley PD, Yates CK. Arthroscopic Bankart suture repair. Am J Sports Med 1993; 76: 348–53
Marcacci M, Zaffagnini S, Petitto A, et al. Arthroscopic management of recurrent anterior dislocation of the shoulder: analysis of technical modifications on the Caspari procedure. Arthroscopy 1996; 11: 144–9
Uribe JW, Hechtman KS. Arthroscopically assisted repair of acute Bankart lesion. Orthopedics 1993; 86: 1019–23
Resch H, Povacz P, Wambacher M, et al. Arthroscopic extraarticular Bankart repair for the treatment of recurrent anterior shoulder dislocation. Arthroscopy 1997; 24: 188–200
Savoie 3rd FH, Miller CD, Field LD. Arthroscopic reconstruction of traumatic anterior instability of the shoulder: the Caspari technique. Arthroscopy 1997; 79: 201–9
Green MR, Christensen KP. Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthroscopy 1993; 24: 371–4
Bacilla P, Field LD, Savoie 3rd FH. Arthroscopic Bankart repair in a high demand patient population. Arthroscopy 1997; 79: 51–60
Naseef 3rd GS, Foster TE, Trauner K, et al. The thermal properties of bovine joint capsule: the basic science of laser- and radiofrequency-induced capsular shrinkage. Am J Sports Med 1997: 670–4
Hayashi K, Markel MD, Thabit 3rd G, et al. The effect of nonablative laser energy on joint capsular properties: an in vitro mechanical study using a rabbit model. Am J Sports Med 1995; 25: 482–7
Schaefer SL, Ciarelli MJ, Arnoczky SP, et al. Tissue shrinkage with the holmium: yttrium aluminum garnet laser. A postoperative assessment of tissue length, stiffness, and structure. Am J Sports Med 1997; 23: 841–8
Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 1996; 78: 1015–23
Wirth MA, Rockwood Jr CA. Operative treatment of irreparable rupture of the subscapularis. J Bone Joint Surg Am 1997; 79: 722–31
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Warme, W.J., Arciero, R.A. & Taylor, D.C. Anterior Shoulder Instability in Sport. Sports Med 28, 209–220 (1999). https://doi.org/10.2165/00007256-199928030-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-199928030-00005