The pathology of the anterior capsule in patients over forty years of age with recurrent shoulder dislocation

Int Orthop. 2016 Jan;40(1):81-6. doi: 10.1007/s00264-015-2864-x. Epub 2015 Jul 8.

Abstract

Purpose: We evaluated the pathologies of anterior capsular mechanism in older patients with recurrent anterior shoulder dislocation in the absence of full-thickness rotator cuff tears.

Methods: Three hundred and ninety-five shoulders with recurrent anterior shoulder dislocation were assessed. The patients were divided into three groups by the age at the first dislocation and the surgical treatment: group A (onset and treatment were at an age over 40 years), group B (onset was at an age under 40 years and treatment was at an age over 40 years) and group C (onset and treatment were at an age under 40 years). Groups A, B and C involved nine, 31 and 355 shoulders, respectively.

Results: The prevalence of an isolated Bankart lesion was 81.7 % in group C, 33.3 % in group A and 64.5 % in group B, and each of A and B was significantly lower than group C. The prevalence of an isolated capsular tear was 3.1 % in group C, while it was 33.3 % in group A, which was significantly higher.

Conclusions: The prevalence of an isolated Bankart lesion was low and the prevalence of a capsular tear was high in older patients. We should keep in mind the existence of a capsular tear in older patients and examine the whole anterior capsular mechanism meticulously.

Keywords: Anterior capsular mechanism; Arthroscopy; Capsular tear; Patients over 40 years of age; Recurrent anterior shoulder dislocation.

MeSH terms

  • Adult
  • Aged
  • Arthroscopy
  • Female
  • Humans
  • Joint Capsule / pathology*
  • Joint Instability / surgery
  • Lacerations
  • Male
  • Middle Aged
  • Prevalence
  • Recurrence
  • Shoulder Dislocation / pathology*
  • Shoulder Dislocation / surgery
  • Shoulder Joint / pathology*
  • Young Adult