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First-time anterior shoulder dislocations: has the standard changed?
  1. Julienne L Boone1,
  2. Robert A Arciero2
  1. 1Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA
  2. 2Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA
  1. Correspondence to Professor Robert A Arciero, The University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030–4037, USA; arciero{at}


The traditional treatment of a first-time anterior shoulder dislocation of reduction and a period of immobilisation should be challenged. The purpose of this review is to assimilate and present the current literature on acute anterior shoulder instability. This involves consideration of the pathoanatomy, natural history and the more recent evaluation of treatment outcomes, which appropriately incorporate quality of life measures in addition to recurrences. There is ample evidence to consider primary stabilisation as an option for treatment in the high-risk group, less than 25 years of age.

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  • Competing interests RAA receives educational/research grant funding from Arthrex. JLB has no competing interests.

  • Provenance and peer review Commissioned; not externally peer reviewed.