Patients with surgically treated first acute anterior shoulder dislocation have less instability than those treated nonsurgically

Clinical Question

Do patients treated surgically following acute anterior shoulder dislocations have less instability than those treated nonsurgically?

Bottom line

In this meta-analysis of only 5 studies, patients 15 to 39 years of age with acute anterior dislocations who were treated surgically were less likely to have recurrent instability than those who were treated nonsurgically. 1a

Study design: Meta-analysis (randomized controlled trials)

Funding: Unknown/not stated

Setting: Various (meta-analysis)


Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI

Discuss this POEM



Excellent new information.

Will change my approach to shoulder dislation

Arup Kumar Dhara

Impact assessment



Treating anterior dislocation of shoulder by surgically and

Good to know

Pieter Richard Verbeek

Recurrent shoulder instability in first time shoulder dislo

Despite the significant methodological limitations of the study the recurrent instability rate for surgical vs non-surgical treatment is quite impressive (6.4% vs 46.6%). I might not be ready to buy into this quite yet but it seems that further high quality studies are urgently needed.


Surgical intervention

There is no reference to whether this has long term risk or benefit — for instance, surgical intervention may not offer any advantage after a certain period of time.