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Shoulder Replacement after Dislocation

Over 50 doctors from nine countries put their patients together for a multicenter study. The topic was shoulder replacement surgery in patients who had previously dislocated the shoulder.

All patients had a condition known as dislocation arthropathy. (Arthropathy is any disease or problem in a joint.) After shoulder dislocation, patients often end up with a weak, unstable joint. Arthritic changes can also develop. Pain, loss of motion, and decreased function send patients to the doctor. Repairing torn muscles and replacing part or all of the joint is often the advised treatment.

The authors of this study looked at the results of shoulder replacement in patients who had an anterior (forward) dislocation. About half the group already had some kind of operation to repair the problem. Age was important to the outcomes. Patients who dislocated their shoulder before age 40 had a better result after shoulder replacement than patients who are over 40 at the time of the injury. The authors also noted that patients who had a shoulder replacement because of osteoarthritis (with no prior dislocations) had better results than those with a dislocation.

The authors conclude that patients with shoulder dislocation get good results with a shoulder replacement. They give one caution. Patients with prior dislocation often have a high number of reoperations and problems after shoulder replacement. No reason was given for this finding.

References: J. Matsoukis, MD, et al. Shoulder Arthroplasty in Patients with a Prior Anterior Shoulder Dislocation. In The Journal of Bone and Joint Surgery. August 2003. Vol. 85-A. No. 8. Pp. 1417-1424.

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