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Management of Midseason Traumatic Anterior Shoulder Instability in Athletes

Owens, Brett D. MD; Dickens, Jonathan F. MD; Kilcoyne, Kelly G. MD; Rue, John‐Paul H. MD

Journal of the American Academy of Orthopaedic Surgeons: August 2012 - Volume 20 - Issue 8 - p 518–526
doi: 10.5435/JAAOS-20-08-518
Review Article

Shoulder dislocation and subluxation injuries are common in young athletes and most frequently occur during the competitive season. Controversy exists regarding optimal treatment of an athlete with an in‐season shoulder dislocation, and limited data are available to guide treatment. Rehabilitation may facilitate return to sport within 3 weeks, but return is complicated by a moderate risk of recurrence. Bracing may reduce the risk of recurrence, but it restricts motion and may not be tolerated in patients who must complete certain sport‐specific tasks such as throwing. Surgical management of shoulder dislocation or subluxation with arthroscopic or open Bankart repair reduces the rate of recurrence; however, the athlete is unable to participate in sport for the remainder of the competitive season. When selecting a management option, the clinician must consider the natural history of shoulder instability, pathologic changes noted on examination and imaging, sport‐ and position‐specific demands, duration of treatment, and the athlete's motivation.

From the John A. Feagin, Jr. Sports Medicine Fellowship, Keller Army Community Hospital, West Point, NY (Dr. Owens), the Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Washington, DC (Dr. Dickens and Dr. Kilcoyne), and the Department of Orthopaedics and Sports Medicine, United States Naval Academy, Annapolis, MD (Dr. Rue).

Dr. Owens or an immediate family member serves as a paid consultant to or is an employee of the Musculoskeletal Transplant Foundation and serves as a board member, owner, officer, or committee member of the American Orthopaedic Society for Sports Medicine and the Society of Military Orthopaedic Surgeons. Dr. Rue or an immediate family member serves as a board member, owner, officer, or committee member of the Society of Military Orthopaedic Surgeons. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Dickens and Dr. Kilcoyne.

© 2012 by American Academy of Orthopaedic Surgeons
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