Aims Extensive literature exists relating to the management of shoulder instability, with a more recent focus on glenoid and humeral bone loss. However, the optimal timing for surgery following a dislocation remains unclear. There is concern that recurrent dislocations may worsen subsequent surgical outcomes, with some advocating stabilization after the first dislocation. The aim of this study was to determine if the recurrence of instability following arthroscopic stabilization in patients without significant glenoid bone loss was influenced by the number of dislocations prior to surgery. Methods A systematic review and meta-analysis was performed using the PubMed, EMBASE, Orthosearch, and Cochrane databases with the following search terms: ((shoulder or glenohumeral) and (dislocation or subluxation) and arthroscopic and (Bankart or stabilisation or stabilization) and (redislocation or re-dislocation or recurrence or instability)). Methodology followed the PRISMA guidelines. Data and outcomes were synthesized by two independent reviewers, and papers were assessed for bias and quality. Results Overall, 35 studies including 7,995 shoulders were eligible for analysis, with a mean follow-up of 32.7 months (12 to 159.5). The rate of post-stabilization instability was 9.8% in first-time dislocators, 9.1% in recurrent dislocators, and 8.5% in a mixed cohort. A descriptive analysis investigated the influence of recurrent instability or age in the risk of instability post-stabilization, with an association seen with increasing age and a reduced risk of recurrence post-stabilization. Conclusion Using modern arthroscopic techniques, patients sustaining an anterior shoulder dislocation without glenoid bone loss can expect a low risk of recurrence postoperatively, and no significant difference was found between first-time and recurrent dislocators. Furthermore, high-risk cohorts can expect a low, albeit slightly higher, rate of redislocation. With the findings of this study, patients and clinicians can be more informed as to the likely outcomes of arthroscopic stabilization within this patient subset.

中文翻译：

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关节镜下稳定复发性不稳定的结果等于原发事件后的稳定。


目的 存在大量与肩关节不稳定管理相关的文献，最近主要关注关节盂和肱骨骨丢失。然而，脱位后手术的最佳时机仍不清楚。人们担心复发性脱位可能会使后续手术结局恶化，一些人主张在首次脱位后稳定病情。本研究的目的是确定无明显关节盂骨丢失的患者关节镜稳定后不稳定的复发是否受到手术前脱位数量的影响。方法 使用 PubMed、EMBASE、Orthosearch 和 Cochrane 数据库进行系统评价和荟萃分析，搜索词如下：（（肩关节或盂肱关节）和（脱位或半脱位）和关节镜和（Bankart 或稳定或稳定）和（再脱位或再脱位或复发或不稳定性））。方法遵循 PRISMA 指南。数据和结局由两名独立评价员综合，并评估论文的偏倚和质量。结果 总体而言，包括 7,995 名肩膀在内的 35 项研究符合分析条件，平均随访时间为 32.7 个月 （12 至 159.5）。首次脱位患者的稳定后不稳定率为 9.8%，复发性脱位者为 9.1%，混合队列为 8.5%。一项描述性分析调查了复发性不稳定或年龄对稳定后不稳定风险的影响，与年龄增加和稳定后复发风险降低有关。 结论 使用现代关节镜技术，肩关节前脱位无关节盂骨丢失的患者术后复发风险预期较低，首次脱位与复发脱位差异无统计学意义。此外，高危人群的再脱位率较低，但略高。根据这项研究的结果，患者和临床医生可以更清楚地了解该患者亚群中关节镜稳定的可能结果。