Should first time shoulder dislocation in young athletes be treated with surgery

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Should first time dislocations in young athletes be treated with Bankart repair or managed with a course of immobilization and physiotherapy?

  1. Jun 21, 2009

    There is no easy answer here, but if the literature suggests that repair cuts down the risk of re-dislocation, then there is a strong argument for surgery, even if you end up operating on many people who never would have re-dislocated (of course, never knowing who these people were--just as "survivors" of radical prostatectomy never find out if they would have been among the many to otherwise not be hard from indolent disease). The point I try to keep in mind (and have my patients consider when making decisions) is that a repeat dislocation is entirely benign. It's not "oops, I did it again"; it's a new impaction injury, and a new invitation to greater arthropathy.

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