text_1: Treating First Time Shoulder Dislocations with Surgery Can Benefit Young Athletes, Study Shows
text_2: This news release describes the results of a study presented at an annual meeting showing that athletes who dislocated their shoulders for the first time and underwent surgery had lower rates of postoperative instability and re-operation when compared with patients who had recurrent dislocations before undergoing surgery. It contains lots of numbers, which we applaud. These numbers are important because they add to the limited database available to help guide treatment for athletes who have suffered a shoulder dislocation. As one study put it in 2014, “there is no consensus on the optimal treatment of in-season athletes with anterior shoulder instability, and limited data are available to guide return to play.” But, in stating a causal relationship, the news release goes beyond what the data support. Specifically, the news release says that the study “demonstrated that surgery after a first-time shoulder dislocation lowered the re-injury risks and need for follow-up surgery when compared to those who were initially treated non-operatively and experienced a repeat dislocation prior to surgery.” The study, which was observational in nature, can only show associations between shoulder surgery and subsequent outcomes — not that surgery after a first-time dislocation was the cause of reduced risks. Also missing from the release: harms, alternative therapies, costs and study limitations. This matters because, in the 2014 prospective study, just 27% of athletes whose shoulders were made unstable due to injury “returned to play and completed the season without subsequent instability.” According to the study abstract, the shoulder is the most common joint dislocation, affecting 2% of the general population, most of them males. And there’s a 50% likelihood of another dislocation after a first one, according to the background into given by the study authors. According to the U.S. Centers for Disease and Control and Prevention, there were some 63 million visits to non-federally employed, office-based physicians specializing in orthopedic surgery in the United States in 2010. Shoulder symptoms ranked among the top four reasons given by patients for visiting orthopedic surgeons.