Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation

M. Olds, R. Ellis, P. Parmar, Paula Kersten

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective To develop a multivariate tool that would predict recurrent instability after a first-time traumatic anterior shoulder dislocation. Methods Participants (aged 16-40 years) were recruited across New Zealand into a prospective cohort study. Baseline data were collected during a telephone interview and through examination of radiology records. Variables associated with recurrent instability were selected for the multivariate logistic regression model using backwards selection (p<0.10). Coefficients for those variables retained in the model were used to develop the predictive tool. Results Among the 128 participants, 36% had redislocated at least once in the first 12 months. Univariate analysis showed an increased likelihood of recurrent dislocation with bony Bankart lesions (OR=3.65, 95% CI 1.05 to 12.70, p=0.04) and participants who had: not been immobilised in a sling (OR = 0.38, 95% CI 0.15 to 0.98, p=0.05), higher levels of shoulder activity (OR=1.13, 95% CI 1.01 to 1.27, p=0.03), higher levels of pain and disability (OR=1.03, 95% CI 1.01 to 1.06, p=0.02), higher levels of fear of reinjury (OR=1.12, 95% CI 1.01 to 1.26, p=0.04) and decreased quality of life (OR=1.01, 95% CI 1.00 to 1.02, p=0.05). There was no significant difference in those with non-dominant compared with dominant shoulder dislocations (p=0.10) or in those aged 16-25 years compared with 26-40 years (p=0.07). Conclusion Six of seven physical and psychosocial factors can be used to predict recurrent shoulder instability following a first-time traumatic anterior shoulder dislocation.

Original languageEnglish
Article numbere000447
JournalBMJ Open Sport & Exercise Medicine
Volume5
Issue number1
DOIs
Publication statusPublished - 7 Mar 2019

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Shoulder Dislocation
Logistic Models
New Zealand
Radiology
Fear
Cohort Studies
Quality of Life
Prospective Studies
Interviews
Psychology
Pain

Bibliographical note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Keywords

  • Shoulder dislocation
  • prospective study
  • fear
  • recurrence
  • Pain
  • pain
  • shoulder dislocation

Cite this

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title = "Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation",
abstract = "Objective To develop a multivariate tool that would predict recurrent instability after a first-time traumatic anterior shoulder dislocation. Methods Participants (aged 16-40 years) were recruited across New Zealand into a prospective cohort study. Baseline data were collected during a telephone interview and through examination of radiology records. Variables associated with recurrent instability were selected for the multivariate logistic regression model using backwards selection (p<0.10). Coefficients for those variables retained in the model were used to develop the predictive tool. Results Among the 128 participants, 36{\%} had redislocated at least once in the first 12 months. Univariate analysis showed an increased likelihood of recurrent dislocation with bony Bankart lesions (OR=3.65, 95{\%} CI 1.05 to 12.70, p=0.04) and participants who had: not been immobilised in a sling (OR = 0.38, 95{\%} CI 0.15 to 0.98, p=0.05), higher levels of shoulder activity (OR=1.13, 95{\%} CI 1.01 to 1.27, p=0.03), higher levels of pain and disability (OR=1.03, 95{\%} CI 1.01 to 1.06, p=0.02), higher levels of fear of reinjury (OR=1.12, 95{\%} CI 1.01 to 1.26, p=0.04) and decreased quality of life (OR=1.01, 95{\%} CI 1.00 to 1.02, p=0.05). There was no significant difference in those with non-dominant compared with dominant shoulder dislocations (p=0.10) or in those aged 16-25 years compared with 26-40 years (p=0.07). Conclusion Six of seven physical and psychosocial factors can be used to predict recurrent shoulder instability following a first-time traumatic anterior shoulder dislocation.",
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author = "M. Olds and R. Ellis and P. Parmar and Paula Kersten",
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Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation. / Olds, M.; Ellis, R.; Parmar, P.; Kersten, Paula.

In: BMJ Open Sport & Exercise Medicine, Vol. 5, No. 1, e000447, 07.03.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation

AU - Olds, M.

AU - Ellis, R.

AU - Parmar, P.

AU - Kersten, Paula

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

PY - 2019/3/7

Y1 - 2019/3/7

N2 - Objective To develop a multivariate tool that would predict recurrent instability after a first-time traumatic anterior shoulder dislocation. Methods Participants (aged 16-40 years) were recruited across New Zealand into a prospective cohort study. Baseline data were collected during a telephone interview and through examination of radiology records. Variables associated with recurrent instability were selected for the multivariate logistic regression model using backwards selection (p<0.10). Coefficients for those variables retained in the model were used to develop the predictive tool. Results Among the 128 participants, 36% had redislocated at least once in the first 12 months. Univariate analysis showed an increased likelihood of recurrent dislocation with bony Bankart lesions (OR=3.65, 95% CI 1.05 to 12.70, p=0.04) and participants who had: not been immobilised in a sling (OR = 0.38, 95% CI 0.15 to 0.98, p=0.05), higher levels of shoulder activity (OR=1.13, 95% CI 1.01 to 1.27, p=0.03), higher levels of pain and disability (OR=1.03, 95% CI 1.01 to 1.06, p=0.02), higher levels of fear of reinjury (OR=1.12, 95% CI 1.01 to 1.26, p=0.04) and decreased quality of life (OR=1.01, 95% CI 1.00 to 1.02, p=0.05). There was no significant difference in those with non-dominant compared with dominant shoulder dislocations (p=0.10) or in those aged 16-25 years compared with 26-40 years (p=0.07). Conclusion Six of seven physical and psychosocial factors can be used to predict recurrent shoulder instability following a first-time traumatic anterior shoulder dislocation.

AB - Objective To develop a multivariate tool that would predict recurrent instability after a first-time traumatic anterior shoulder dislocation. Methods Participants (aged 16-40 years) were recruited across New Zealand into a prospective cohort study. Baseline data were collected during a telephone interview and through examination of radiology records. Variables associated with recurrent instability were selected for the multivariate logistic regression model using backwards selection (p<0.10). Coefficients for those variables retained in the model were used to develop the predictive tool. Results Among the 128 participants, 36% had redislocated at least once in the first 12 months. Univariate analysis showed an increased likelihood of recurrent dislocation with bony Bankart lesions (OR=3.65, 95% CI 1.05 to 12.70, p=0.04) and participants who had: not been immobilised in a sling (OR = 0.38, 95% CI 0.15 to 0.98, p=0.05), higher levels of shoulder activity (OR=1.13, 95% CI 1.01 to 1.27, p=0.03), higher levels of pain and disability (OR=1.03, 95% CI 1.01 to 1.06, p=0.02), higher levels of fear of reinjury (OR=1.12, 95% CI 1.01 to 1.26, p=0.04) and decreased quality of life (OR=1.01, 95% CI 1.00 to 1.02, p=0.05). There was no significant difference in those with non-dominant compared with dominant shoulder dislocations (p=0.10) or in those aged 16-25 years compared with 26-40 years (p=0.07). Conclusion Six of seven physical and psychosocial factors can be used to predict recurrent shoulder instability following a first-time traumatic anterior shoulder dislocation.

KW - Shoulder dislocation

KW - prospective study

KW - fear

KW - recurrence

KW - Pain

KW - pain

KW - shoulder dislocation

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