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Shoulder dislocation in athletes: overview and update on treatment

Mariano Lopez-Franco, David Blanco-Diaz, Maria Aranzazu Murciano-Anton

Shoulder dislocation result in a significant amount of lost practice and game time, and has physical and psychological consequences for the athlete. It is paramount to identify the correct pathogenesis of instability so that treatment can be appropriately tailored to the patient’s needs. When medical literature is analyzed searching for the most suitable treatment in a patient with recurrent shoulder dislocation, we must evaluate the overall outcomes using the different procedures of treatment, but we should choose a scoring system reliable, valid, and responsive in patients with instability. Nonoperative treatment may be useful for the in-season athlete looking to complete the season and then undergo off-season stabilization. Primary surgical treatment after first-time traumatic anterior shoulder dislocation may be considered to avoid secondary damage to articular structures. Open or current arthroscopic repair techniques have shown equivalent results. In considering a surgical procedure involving bone defects, the surgeons always have to measure the length and take into account the location of the injury. Isolated soft tissue repair is generally not sufficient for the surgical management of patients with large bone defects. Latarjet procedure provides a glenoid bony augmentation and the transferred conjoined tendon creates a dynamic belt that reinforces the weak anteroinferior capsule. Remplissage arthroscopic technique can be useful in engaging Hill-Sachs lesions. Arthroscopically aided anterior capsular reinforcement can be used when there is insufficient quantity and quality of the anterior capsuloligamentous tissue.

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