117. GENERALIZED LIGAMENTOUS LAXITY AS A PREDISPOSING FACTOR FOR PRIMARY ANTERIOR SHOULDER DISLOCATION

Abstract

Purpose: To determine whether generalized ligamentous laxity is a predisposing factor for primary traumatic anterior shoulder dislocation in young, active patients.

Method: Prospective case series with age and sex matched controls. The Hospital Del Mar Criteria was utilized to measure generalized ligamentous laxity. Fifty-seven (n=57) consecutive individuals (age< 30) sustaining a primary traumatic anterior shoulder dislocation between 2003 and 2006 were examined for hyperlaxity. The control group was comprised of seventy-two (n=72) undergraduate university students without a prior history of shoulder dislocation or anterior cruciate ligament injury.

Results: After adjusting for age and sex, the prevalence of hyperlaxity in the study group was 32.8% compared with 10.4% in the control group (p< 0.01). The prevalence of increased contralateral shoulder external rotation (> 85o) was 40.3% in the study group compared with 20.8% in the control group (p< 0.03). Among males, the prevalence of hyperlaxity was 28.3% in the study group and 5.3% in the controls (p< 0.01).

Conclusion: Although several studies have looked at the variables affecting shoulder instability, generalized ligamentous laxity (as measured by validated criteria) has not previously been identified as a predisposing factor for primary traumatic shoulder dislocation. This study demonstrates that generalized joint laxity and increased external rotation in the contralateral shoulder were found to be more common in patients who had sustained a primary shoulder dislocation. These observations may suggest a role for shoulder-specific proprioceptive and strength training protocols in hyperlax individuals participating in high-risk sports. Furthermore, the implications of hyperlaxity on the surgical management of traumatic primary shoulder instability are uncertain.