{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:41:16Z","timestamp":1762443676520,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to investigate the outcomes of conservative treatment for recurrent shoulder dislocation without subjective apprehension, despite the presence of a Bankart lesion or glenoid defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed for 92 patients with recurrent shoulder dislocation treated with conservative treatment due to negative apprehension between 2009 and 2018. The failure of the conservative treatment was defined as a dislocation or subluxation episode or subjective feeling of instability based on a positive apprehension. The Kaplan\u2013Meier method was used to estimate failure rates over time, and a receiver operating characteristic (ROC) curve was constructed to determine a cut\u2010off value for a glenoid defect. The clinical outcomes were compared between patients who completed conservative treatment without recurrence of instability (Group A) and those who failed and subsequently underwent surgical treatment (Group B) using shoulder functional scores and sports\/recreation activity level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This retrospective study included 61 of 92 eligible patients with recurrent shoulder dislocation. Among the 61 patients, conservative treatment failed in 46 (75.4%) over the 2\u2010year study period. The cut\u2010off value for a glenoid defect was 14.4%. The association between glenoid defect size (\u2265\u200914.4% or as a continuous variable) and survival was statistically significant (p\u2009=\u20090.039 and p\u2009&lt;\u20090.001, respectively). The mean glenoid defect size in Group B increased from 14.6\u2009\u00b1\u20093.0% to 17.3\u2009\u00b1\u20093.1% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and clinical outcomes for Group A were inferior to those for Group B at the 24\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Conservative treatment for recurrent shoulder dislocation in patients without subjective apprehension showed a high failure rate during the study period, especially if the glenoid defect was\u2009\u2265\u200914.4% in size. Despite clinical improvement in patients who completed conservative treatment without recurrence, functional outcome scores and sport\/recreation activity levels were better in the patients who underwent arthroscopic Bankart repair. Therefore, for recurrent anterior shoulder instability, even without subjective apprehension, surgical treatment is warranted over conservative treatment.<\/jats:p><jats:p><jats:bold>Level of evidence:<\/jats:bold> Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07028-w","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T11:04:01Z","timestamp":1655982241000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High failure rate after conservative treatment for recurrent shoulder dislocation without subjective apprehension on physical examination"],"prefix":"10.1002","volume":"31","author":[{"given":"Woo\u2010Sung","family":"Do","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo\u2010Hyung","family":"Kim","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon\u2010Ryul","family":"Lim","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae\u2010Hwan","family":"Yoon","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung\u2010Hwan","family":"Shin","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8147-6136","authenticated-orcid":false,"given":"Yong\u2010Min","family":"Chun","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.5397\/cise.2016.19.2.78"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43465\u2010020\u201000348\u20104"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.10.004"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519831286"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006176\u20101"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2022.01.001"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178\u2010017\u20109437\u20100"},{"key":"e_1_2_9_9_2","doi-asserted-by":"crossref","unstructured":"HaskoorJ WangKY BestMJ AgarwalAR MikulaJD SharmaS NayarSK SrikumaranUTrends in utilization and patient demographics for shoulder 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December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that no benefits have been received or will be received from a commercial party related to the subject of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Institutional Review Board for Severance Hospital at the Yonsei University College of Medicine (IRB No. 4-2021-00224). All the procedures performed in the study were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}