Strong Evidence Favors Surgery After One Shoulder Dislocation

A well-done meta-analysis points hard toward early shoulder stabilization

What’s the Claim?

A meta-analysis of five randomized trials found that surgical stabilization of first-time shoulder dislocations resulted in far less recurrent instability (6% versus 47%) and subsequent surgery for instability (4% versus 31%) than did nonsurgical treatment. The same main findings held in the four of five trials that immobilized patients in internal rotation. Outcomes scores and range of motion each were reported in three of the five trials included in this meta-analysis, but they showed no clear benefit in favor of either approach. There were not enough complications in either group to analyze. Importantly, the mean age in these studies was 24 years (range 15 to 39 years), and nearly 90% of the patients were men.

How’s It Stack Up?