ArticleArthroscopy, sports medicine, and rehabilitation2023
Patients Aged >50 Years With Anterior Shoulder Instability Have a Decreased Risk of Recurrent Dislocation After Operative Treatment Compared With Non-Operative Treatment.
Article in Arthroscopy, sports medicine, and rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Management of anterior shoulder instability in patients aged 40 and older: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Pooled it
- Clinical outcomes following concomitant arthroscopic rotator cuff repair and anterior shoulder stabilization: a systematic review and meta-analysis.JSES reviews, reports, and techniques · 2026Review
- Article
- The impact of randomized controlled trials on the management of anterior shoulder instability: A bibliometric and altmetrics analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Approach to Treating Patients after First-time Anterior Shoulder Instability: What Does the Evidence Say?Current reviews in musculoskeletal medicine · 2025Review
- Outcomes of primary arthroscopic shoulder stabilization in active patients over 40-results at a mean follow-up of 7 years.JSES international · 2024Article
- Arthroscopic Humeral Avulsion of the Glenohumeral Ligament (HAGL) Repair Utilized Accessory Posterior Portal in the Beach-Chair Position.Arthroscopy techniques · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To compare the clinical outcomes of operative and nonoperative management, identify risk factors for recurrent instability, and identify risk factors for progression to surgery after failed nonoperative management for patients with first-time anterior shoulder dislocation after the age of 50 years. Methods: An established geographic medical record system was used to identify patients who experienced a first-time anterior shoulder dislocation after the age of 50 years. Patient medical records were reviewed to identify treatment decisions and outcomes of interest, including rates of frozen shoulder and nerve palsy, progression to osteoarthritis, recurrent instability, and progression to surgery. Outcomes were evaluated using Chi-square tests and survivorship curves were generated using Kaplan-Meier methods. A Cox model was developed to evaluate for potential risk factors of recurrent instability and progression to surgery after an initial trail of at least 3 months of nonoperative treatment. Results: 179 patients were included with a mean follow-up of 11 years. 14% ( Conclusions: Although the majority of patients >50 years that experience ASI are treated nonoperatively, those that require surgery tend to have more significant injury pathology, a lower risk of recurrent instability after surgery, but a higher progression to osteoarthritis compared to patients that do not require surgical intervention. There was no difference in pain severity at final follow-up, rates of frozen shoulder or nerve palsy between patients who underwent initial nonoperative treatment after instability and those who underwent surgery. A history of multiple instability episodes prior to presentation was the greatest predictor of recurrent instability and failure of nonoperative treatment and progression to surgery. Level of Evidence: Level III, retrospective cohort study.
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Registered trials
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