The shoulder sacrifices stability for mobility allowing incredible function of the arm and hand. The downside of this mobility is an increased risk of joint injury after trauma including shoulder dislocations. These injuries most commonly occur when the ball of the arm bone is pushed forward and downward beyond its’ anatomical limits. The high forces experienced during this injury can result in a tear of the ligaments surrounding the socket (labrum) and a potential fracture of the socket (bankart lesion). Shoulder dislocations commonly occur in younger male patients and are associated with high recurrence rates (up to 100%) and instability in the affected shoulder. Most researchers and surgeons advise surgery for these injuries secondary to the high rates of recurrence, instability, and shoulder pain.
A recent review of the literature was published comparing outcomes between conservative management, including Physical Therapy, and surgery for shoulder dislocation (Hurley et al. Arthroscopy. 2020). Authors included 10 studies of over 500 patients with first time traumatic anterior shoulder dislocations. They reported traditional arthroscopic bankart repair resulted in lower rates of subsequent instability and surgical care among these patients compared to conservative treatment. Specifically, surgically treated patients had a 7 fold reduction in recurrent shoulder dislocations and a higher return to sport. Anterior shoulder dislocation in a younger male patient remains one of the few diagnoses to improve with early surgery vs. a trial of Physical Therapy.