A TOOL TO PREDICT RECURRENT SHOULDER INSTABILITY AFTER A FIRST TIME SHOULDER DISLOCATION
We have recently published a tool (Predict Recurrent Instability of the Shoulder (PRIS)) that enables clinicians to predict recurrent shoulder instability after a first time traumatic anterior shoulder dislocation (FTASD). We undertook two blinded prospective cohort studies in New Zealand, the first to develop the tool (which can be read here), and the second to validate the tool. The PRIS tool shows that we can predict who is not going to have recurrent shoulder instability with 80% accuracy. The following variables can be used to predict recurrent instability in a population of people with FTASD.
VARIABLES THAT PREDICT RECURRENT SHOULDER INSTABILITY
Variables that have been shown to predict recurrent shoulder instability after a FTASD are age (16-25 years), dislocation in the dominant arm, immobilisation, bony bankart lesion, SPADI scores and TSK-11 scores. Our research has shown that the following variables predict recurrent shoulder instability with a specificity of 95%, accuracy of 80 % and sensitivity of 35%. This means that the tool is good at finding people who are not going to have recurrent shoulder instability with 80% accuracy. However, it is not that good at finding people who are going to have recurrent shoulder instability. Further work is required to improve the sensitivity of this tool.
Our data shows that the following equation is able to predict shoulder instability. Please enter your patient’s details in the following boxes to aid decision-making regarding recurrent anterior shoulder instability
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