Recurrent anterior shoulder instability: Why do the patientsdecide on the treatment late?
Recurrent anterior shoulder instability: Why do the patientsdecide on the treatment late?
Aim: Anterior shoulder instability is a condition that frequently occurs in young and active patients and reduces quality of life. In their daily practice, the authors have noticed that patients presenting to their clinic with anterior shoulder instability took longer to decide on treatment compared with reports in the literature. The aim of the present study was to investigate the reasons why patients who experience recurrent anterior shoulder instability delay treatment decisions in Turkey. Materials and Methods: A total of 49 patients, who underwent arthroscopic repairs due to anterior shoulder instability between March 2015 and January 2019, were administered a survey prepared by the authors at regular patient follow-ups.Results: Patients participating in this study experienced an average of 21.78 (range, 2–100) dislocations in the period from the first episode of dislocation to surgery. The mean time from the first dislocation to surgery was 5.5 years (range, 1–266 months). Academic degree, living area, distance from hospital, first dislocation time, first episode to surgery time, dislocation count, operation advicing time after dislocation, patient decision after dislocation, type of surgery were statistically insignificant. Conclusion: Patient responses to the survey questions indicated that delayed decisions for surgery resulted from concerns with absence from work. We believe that patients’ inclination to delay surgery due to their work and financial concerns are understandable considering existing conditions in Turkey. The high number of patients examined daily in our country may be the most important reason for incomplete information of patients.
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- 1. Walton J, Paxinos A, Tzannes A, et al. The unstable shoulder in the adolescent athlete. Am J Sports Med 2002;30:758-67.
- 2. Leroux T, Wasserstein D, Veillette C, et al.. Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada. Am J Sports Med 2014;42:442-50.
- 3. Robinson MC, Howes J, Helen M, et al. Functional outcome and risk of recurrent instability dislocation in young patients. J Bone Jt Surg 2006;88:2326-36.
- 4. Robinson MC, Jenkins PJ, White TO, et al. Primary arthroscopic stabilization for a first-time anterior dislocation of the shoulder. A ramdomized, doubleblind trial. J Bone Joint Surg Am 2008;90:708-21.
- 5. Ono Y, Dávalos Herrera DA, Woodmass JM, et al. Long-term outcomes following isolated arthroscopic Bankart repair: a 9- to 12-year follow-up. JSES Open Access 2019;3:189-93.
- 6. Aboalata M, Plath JE, Seppel G, et al. Results of arthroscopic bankart repair for anterior-inferior shoulder instability at 13-year follow-up. Am J Sports Med 2017;45:782-7.
- 7. Castagna A, Markopoulos N, Conti M, et al. Arthroscopic bankart suture-anchor repair: Radiological and clinical outcome at minimum 10 years of follow-up. Am J Sports Med 2010;38:2012-6.
- 8. Kavaja L, Pajarinen J, Sinisaari I, et al. Arthrosis of glenohumeral joint after arthroscopic Bankart repair: A long-term follow-up of 13 years. J Shoulder Elb Surg 2012;21:350-5.
- 9. Zhu M, Chen JY, Chong HC, et al. Comparative study on clinical results of arthroscopic repair of anteroinferior, superior, and combined glenoid labral tear. J Orthop Surg 2018;26:1-6.
- 10. Williams AA, Mancini NS, Kia C, et al. Recurrent shoulder instability: Do morbidity and treatment differ based on insurance? Orthop J Sports Med 2019;26:7- 4
- 11. Parmar RS, Kapoor S, Sharma B. Arthroscopic Bankart repair following traumatic recurrent shoulder dislocation: A prospective review of 30 cases. J Orthop Surg 2019;27:1-7.
- 12. Kuhn JE. Treating the initial anterior shoulder dislocation: an evidence-based medicine approach. Sports Med Arthosc Rev 2006;14:192-8.