Publication:

Diagnostic overview of nature and pathogenesis of shoulder dislocation

Background Shoulder dislocation, soft tissue and bony injuries around shoulder has close relation and hence, detail investigation and diagnosis plays a crucial role in prognosis and further treatment.

Methods The study of diagnostic arthroscopy aimed to determine the incidence of secondary intra-articular shoulder lesions in acute and chronic anterior shoulder instability patients. Study investigated the occurrence of intra-articular shoulder lesions in a series of 30 patients with acute and chronic traumatic anterior instability.

Results Prospective observational study was done on patients with acute shoulder dislocation. After ab arthroscopic evaluation, majority 77% of patients had capsulo-labral detachments. 61% of first dislocations showed capsulo-labral detachment/Bankart lesions and all the recurrent dislocations had partial or complete capsule-labral detachment or Bankart lesions. Glenohumeral ligament integrity was disturbed in 58% of recurrent and that of 11% of first time shoulder dislocation cases. Hillsach lesions are in total of 57% of all soft tissue injuries. Bony Bankart lesions were found in 50% of recurrent dislocations. Rotator tears are mainly in recurrent dislocation cases mainly >40 years of age.

Conclusions Patients with chronic shoulder instability are more likely to have secondary intra-articular lesions, compared to those with acute, likely due to the repeated episodes of dislocation or subluxation. These associated lesions are a consequence of the ongoing instability, which leads to additional damage within the joint. Early intervention plays an important role, as the conditions for surgical intervention are optimal after initial shoulder dislocation.