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As sports orthopaedic surgeons and sports medicine clinicians, it was with great excitement that we first read the manuscript of Margie Olds and colleagues regarding ‘Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis’.1 The authors had nicely defined their population and purpose, and for us as clinicians, it heralded great potential regarding patient education as well as treatment options (when should I pull the trigger and perform surgical stabilisation for a first time dislocator?).
The authors have done a wonderful job reviewing the global topic with particular documentation on the impact on the New Zealand healthcare system. They remind us, with supported references, of the known risk factors, including age; gender; hypermobility; occupational demands; sports specific demands, particularly those of overhead or collision sports; and also about pathological factors such as Hill-Sach's lesions or bony Bankart lesions. Their conclusions support commonly accepted dictums when caring for patients with first time dislocators: age is …