Abstract
We investigated the results of surgical treatment for recurrent anterior dislocation of the shoulder in patients aged 50 years old and more. Ten patients aged 50 to 72 years old (9 women, 1 man) were reviewed. They were followed-up from 12 to 106 months after surgery. We studied the pathologic features and the treatment for each case. Also we estimated the results of surgery by using Rowe's scoring system. Bankart lesion with a bony lesion and an over medium degree Hill-Sachs lesion was observed in 5 patients who had the initial dislocation at under 50 (18 to 47 years old, average : 29 years old). We performed Bankart procedure on all the patients, and the results were excellent with a sore of 90 to 100. Three cases of rotator cuff tear were observed in 5 patients who had an initial dislocation at 50 years old and over (61 to 69 years old, average : 66 years old). Two of 3 cases were massive tears. Bankart lesions were observed in 3 patients. We repaired the rotator cuff tears and acromioplasty in 2 patients, and added a modified Bristow method in one of them. Also we performed Bankart procedure in the other 3 patients and added a modified Bristow method to one of them. The results showed a score of 75 to 90. Patients who had their initial dislocation at a young age often have Bankart lesion alone. In comparison with them, patients who had initial dislocation at 50 years old and over have the same pathological features as young people, and or with massive rotator cuff tears. It is important to grasp the pathological feature ahead of an operation, and to choose a suitable surgical treatment as to the operation for a recurrent anterior dislocation of the shoulder for middle-aged patients.
