Shoulder Dislocation | Arthroscopic Treatment | Athletic Injury

Dr. Peter Millett discusses the process once the patient has been reduced after a shoulder dislocation. Imaging is initially inspected to find the degree of damage and then assess weather or not they need treatment. In most cases, patients do not want to have surgery, but we know that athletes have very high recurrence rates. The primary risk factors are the age of the patient, gender, population, and immobilization. The activity level also plays a roll in shoulder dislocation recurrence.

The question often comes up for in season athletes - should they stop participating or should they wait till the end of the season - it depends on the activity that they are doing, if they are doing a sport that could lead to a life threatening problem then we typically do not allow them to return back to their sports. In many athletes that Dr. Millett has treated, have played the rest of the season.

Why do we recommend acute surgery? There have been a number of studies that have shown that acute repair lead to improved outcomes. There are really big differences between surgical and non-surgical treatment.

In this case example, an acute dislocation with a bony bankart lesion is repaired. His other side had multiple dislocations and required an iliac crest bone graft procedure.

In high risk groups, acute repair leads to better outcomes. There is the argument - why not let them experience another dislocation? There is a lot damage that can occur when the patient does not get treatment. Loose bodies can cause additional articular damage. Dr. Millett's current approach is a shared decision making. He recommends acute repair to:

- Athletic population
- Males
- Collision athletes
- Loose bodies
- Boney Bankart lesions
- Associated RTC tears

Many patients still take their chances and do not get acute repair. In conclusion, early reduction can be safe and effective. Early reduction may improve patient oriented outcomes.