{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:40:30Z","timestamp":1790775630681,"version":"4.1.0"},"reference-count":53,"publisher":"International Journal of Sports Physical Therapy","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Shoulder instabilities constitute a large proportion of shoulder injuries and have a wide range of presentations. While evidence regarding glenohumeral dislocations and associated risk factors has been reported, less is known regarding the full spectrum of instabilities and their risk factors.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n The purpose of this systematic review was to identify modifiable risk factors to guide patient management decisions with regards to implementation of interventions to prevent or reduce the risk of shoulder instability.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Systematic Review<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic, computerized search of electronic databases (CINAHL, Cochrane, Embase, PubMed, SportDiscus, and Web of Science) was performed. Inclusion criteria were: (1) a diagnosis of shoulder instability (2) the statistical association of at least one risk factor was reported, (3) study designs appropriate for risk factors, (4) written in English, and (5) used an acceptable reference standard for diagnosed shoulder instability. Titles and abstracts were independently screened by at least two reviewers. All reviewers examined the quality studies using the Newcastle-Ottawa Scale (NOS). At least two reviewers independently extracted information and data regarding author, year, study population, study design, criterion standard, and strength of association statistics with risk factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Male sex, participation in sport, hypermobility in males, and glenoid index demonstrated moderate to large risk associated with first time shoulder instability. Male sex, age <30 years, and history of glenohumeral instability with concomitant injury demonstrated moderate to large risk associated with recurrent shoulder instability.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n There may be an opportunity for patient education in particular populations as to their increased risk for suffering shoulder instability, particularly in young males who appear to be at increased risk for recurrent shoulder instability.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level III<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.116278","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T22:17:58Z","timestamp":1714515478000},"source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors Associated with First Time and Recurrent Shoulder Instability: A Systematic Review"],"prefix":"10.26603","volume":"19","author":[{"given":"Alexis","family":"Wright","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wvpxv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Tufts University","department":["Department of Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Ness","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wvpxv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Tufts University","department":["Department of Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Spontelli-Gisselman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wvpxv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Tufts University","department":["Department of Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Gosselin","sequence":"additional","affiliation":[{"name":"Duke Health","department":["Pediatric Physical Therapy and Occupational Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Cleland","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wvpxv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Tufts University","department":["Department of Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Wassinger","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wvpxv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Tufts University","department":["Department of Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2024,5,1]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1177\/0363546514551149","article-title":"Risk factors for anterior glenohumeral instability","volume":"42","author":"Brett D. Owens","year":"2014","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"7","key":"ref2","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1177\/0363546506295179","article-title":"The incidence and characteristics of shoulder instability at the United States Military Academy","volume":"35","author":"Brett D. Owens","year":"2007","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"19","key":"ref3","doi-asserted-by":"publisher","first-page":"11857","DOI":"10.3390\/ijerph191911857","article-title":"Shoulder dislocation incidence and risk factors-Rural vs. urban populations of Poland","volume":"19","author":"Karol Szyluk","year":"2022","journal-title":"International Journal of Environmental Research and Public Health","ISSN":"https:\/\/id.crossref.org\/issn\/1660-4601","issn-type":"print"},{"issue":"7","key":"ref4","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1177\/0363546515577622","article-title":"Posterior instability of the shoulder: A systematic review and meta-analysis of clinical outcomes","volume":"43","author":"Jeffrey M. DeLong","year":"2015","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"48","key":"ref5","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1051\/sicotj\/2021048","article-title":"Current concepts in anterior glenohumeral instability: diagnosis and treatment","volume":"7","author":"Daniel Moya","year":"2021","journal-title":"SICOT-J","ISSN":"https:\/\/id.crossref.org\/issn\/2426-8887","issn-type":"print"},{"issue":"3","key":"ref6","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.jseint.2020.04.023","article-title":"The financial burden associated with multiple shoulder dislocations and the potential cost savings of surgical stabilization","volume":"4","author":"Shea M. Comadoll","year":"2020","journal-title":"JSES International","ISSN":"https:\/\/id.crossref.org\/issn\/2666-6383","issn-type":"print"},{"issue":"2","key":"ref7","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/jrsm.1535","article-title":"Introduction to PRISMA 2020 and implications for research synthesis methodologists","volume":"13","author":"Matthew J. Page","year":"2022","journal-title":"Research Synthesis Methods","ISSN":"https:\/\/id.crossref.org\/issn\/1759-2879","issn-type":"print"},{"issue":"2","key":"ref8","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/jebm.12427","article-title":"The ROBINS-I and the NOS had similar reliability but differed in applicability: A random sampling observational studies of systematic reviews\/meta-analysis","volume":"14","author":"Yuhui Zhang","year":"2021","journal-title":"Journal of Evidence-Based Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/1756-5383","issn-type":"print"},{"issue":"6","key":"ref9","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1159\/000131672","article-title":"Association between metabolic syndrome and risk of stroke: a meta-analysis of cohort studies","volume":"25","author":"Wei Li","year":"2008","journal-title":"Cerebrovascular Diseases","ISSN":"https:\/\/id.crossref.org\/issn\/1015-9770","issn-type":"print"},{"issue":"4","key":"ref10","doi-asserted-by":"publisher","first-page":"80","DOI":"10.13105\/wjma.v5.i4.80","article-title":"Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale","volume":"5","author":"Claudio Luchini","year":"2017","journal-title":"World Journal of Meta-Analysis","ISSN":"https:\/\/id.crossref.org\/issn\/2308-3840","issn-type":"print"},{"issue":"7","key":"ref11","doi-asserted-by":"publisher","first-page":"373","DOI":"10.2519\/jospt.2020.9225","article-title":"Posterior shoulder instability classification, assessment, and management: An international delphi study","volume":"50","author":"Jackie Sadi","year":"2020","journal-title":"Journal of Orthopaedic & Sports Physical Therapy","ISSN":"https:\/\/id.crossref.org\/issn\/0190-6011","issn-type":"print"},{"key":"ref12","article-title":"Comparing D-dimer assays using likelihood ratios and Fagan nomograms","author":"S. Ekelund","year":"2016"},{"issue":"5","key":"ref13","first-page":"56","article-title":"Characterization of shoulder instability in Rhode Island: Incidence, surgical stabilization, and recurrence","volume":"105","author":"J.A. Albright","year":"2022","journal-title":"R I Med J"},{"issue":"5","key":"ref14","doi-asserted-by":"publisher","first-page":"439","DOI":"10.2106\/jbjs.l.00252","article-title":"History of shoulder instability and subsequent injury during four years of follow-up: a survival analysis","volume":"95","author":"Kenneth L. Cameron","year":"2013","journal-title":"Journal of Bone and Joint Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"8","key":"ref15","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/j.jse.2010.02.005","article-title":"Generalized ligamentous laxity as a predisposing factor for primary traumatic anterior shoulder dislocation","volume":"19","author":"Jaskarndip Chahal","year":"2010","journal-title":"Journal of Shoulder and Elbow Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/1058-2746","issn-type":"print"},{"issue":"6","key":"ref16","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.jse.2014.01.018","article-title":"Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation","volume":"23","author":"Kamran Heidari","year":"2014","journal-title":"Journal of Shoulder and Elbow Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/1058-2746","issn-type":"print"},{"issue":"1","key":"ref17","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/bf00431367","article-title":"Prognosis of primary anterior shoulder dislocation in young adults","volume":"110","author":"M. A. Hoelen","year":"1990","journal-title":"Archives of Orthopaedic and Trauma Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0936-8051","issn-type":"print"},{"issue":"11","key":"ref18","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1249\/mss.0000000000001011","article-title":"Incidence of Shoulder Dislocations and the Rate of Recurrent Instability in Soldiers","volume":"48","author":"JOSEPH R. Kardouni","year":"2016","journal-title":"Medicine & Science in Sports & Exercise","ISSN":"https:\/\/id.crossref.org\/issn\/0195-9131","issn-type":"print"},{"issue":"12","key":"ref19","doi-asserted-by":"publisher","first-page":"2432","DOI":"10.1177\/0363546508320805","article-title":"Type I collagen alpha1 Sp1 polymorphism and the risk of cruciate ligament ruptures or shoulder dislocations","volume":"36","author":"Shwan Khoschnau","year":"2008","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"7","key":"ref20","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1055\/s-0043-106190","article-title":"A Genetic Marker Associated with Shoulder Dislocation","volume":"38","author":"Stuart Kim","year":"2017","journal-title":"International Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0172-4622","issn-type":"print"},{"issue":"9","key":"ref21","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1177\/0363546515591996","article-title":"The epidemiology of primary anterior shoulder dislocations in patients aged 10 to 16 years","volume":"43","author":"Timothy Leroux","year":"2015","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"3","key":"ref22","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.arthro.2008.12.007","article-title":"The treatment of traumatic anterior instability of the shoulder: nonoperative and surgical treatment","volume":"25","author":"Robert H. Brophy","year":"2009","journal-title":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0749-8063","issn-type":"print"},{"issue":"2","key":"ref23","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1177\/0363546513510391","article-title":"Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada","volume":"42","author":"Timothy Leroux","year":"2014","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"10","key":"ref24","doi-asserted-by":"publisher","first-page":"897","DOI":"10.2106\/jbjs.j.00416","article-title":"Immobilization in external rotation after primary shoulder dislocation did not reduce the risk of recurrence: a randomized controlled trial","volume":"93","author":"Sigurd Liavaag","year":"2011","journal-title":"The Journal of Bone and Joint Surgery-American Volume","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"1","key":"ref25","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00068-001-1070-2","article-title":"Age-dependent prognosis following conservative treatment of traumatic anterior shoulder dislocation","volume":"27","author":"Helmut Lill","year":"2001","journal-title":"European Journal of Trauma","ISSN":"https:\/\/id.crossref.org\/issn\/1439-0590","issn-type":"print"},{"issue":"22","key":"ref26","doi-asserted-by":"publisher","first-page":"12026","DOI":"10.3390\/ijerph182212026","article-title":"Instability severity index score does not predict the risk of shoulder dislocation after a first episode treated conservatively","volume":"18","author":"Umile Giuseppe Longo","year":"2021","journal-title":"International Journal of Environmental Research and Public Health","ISSN":"https:\/\/id.crossref.org\/issn\/1660-4601","issn-type":"print"},{"issue":"2","key":"ref27","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.otsr.2018.10.007","article-title":"Immobilization in external rotation after primary shoulder dislocation reduces the risk of recurrence in young patients. A randomized controlled trial","volume":"106","author":"Jean-Christophe Murray","year":"2020","journal-title":"Orthopaedics & Traumatology: Surgery & Research","ISSN":"https:\/\/id.crossref.org\/issn\/1877-0568","issn-type":"print"},{"issue":"2","key":"ref28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/s1058-2746(05)80063-1","article-title":"Incidence and causes of shoulder girdle injuries in an urban population","volume":"4","author":"Anders Nordqvist","year":"1995","journal-title":"Journal of Shoulder and Elbow Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/1058-2746","issn-type":"print"},{"issue":"11","key":"ref29","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1016\/j.injury.2010.12.004","article-title":"Glenohumeral dislocations in snowboarding and skiing","volume":"42","author":"Hiroyasu Ogawa","year":"2011","journal-title":"Injury","ISSN":"https:\/\/id.crossref.org\/issn\/0020-1383","issn-type":"print"},{"issue":"11","key":"ref30","doi-asserted-by":"publisher","first-page":"2645","DOI":"10.1177\/0363546513501508","article-title":"Risk factors for posterior shoulder instability in young athletes","volume":"41","author":"Brett D. Owens","year":"2013","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"3-4","key":"ref31","doi-asserted-by":"publisher","first-page":"e487","DOI":"10.1093\/milmed\/usz340","article-title":"Incidence and risk factors of upper extremity injuries in young adult men: A nationwide registry-based study of 128,714 conscripts","volume":"185","author":"Harri Pihlajam\u00e4ki","year":"2020","journal-title":"Military Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0026-4075","issn-type":"print"},{"issue":"1","key":"ref32","doi-asserted-by":"publisher","first-page":"2325967113489097","DOI":"10.1177\/2325967113489097","article-title":"Rotator cuff weakness is not a risk factor for first-time anterior glenohumeral instability","volume":"1","author":"Christopher J. Roach","year":"2013","journal-title":"Orthopaedic Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/2325-9671","issn-type":"print"},{"issue":"2","key":"ref33","first-page":"300","article-title":"Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study","volume":"80","author":"S. Kirkley","year":"1998","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"ref34","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1302\/0301-620x.97b4.34989","article-title":"The natural history of primary anterior dislocation of the glenohumeral joint in adolescence","volume":"97-B","author":"S. B. Roberts","year":"2015","journal-title":"The Bone & Joint Journal","ISSN":"https:\/\/id.crossref.org\/issn\/2049-4394","issn-type":"print"},{"issue":"11","key":"ref35","doi-asserted-by":"publisher","first-page":"2326","DOI":"10.2106\/jbjs.e.01327","article-title":"Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients","volume":"88","author":"C. Michael Robinson","year":"2006","journal-title":"The Journal of Bone & Joint Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"9","key":"ref36","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.2106\/00004623-200209000-00007","article-title":"Redislocation of the shoulder during the first six weeks after a primary anterior dislocation: risk factors and results of treatment","volume":"84","author":"C. M. Robinson","year":"2002","journal-title":"The Journal of Bone and Joint Surgery-American Volume","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"17","key":"ref37","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.2106\/jbjs.j.00973","article-title":"The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder","volume":"93","author":"C. Michael Robinson","year":"2011","journal-title":"Journal of Bone and Joint Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"2","key":"ref38","doi-asserted-by":"publisher","first-page":"2309499018768100","DOI":"10.1177\/2309499018768100","article-title":"Analysis of glenohumeral morphological factors for anterior shoulder instability and rotator cuff tear by magnetic resonance imaging","volume":"26","author":"B Saygi","year":"2018","journal-title":"Journal of Orthopaedic Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/2309-4990","issn-type":"print"},{"issue":"935","key":"ref39","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1259\/bjr\/27340997","article-title":"Coracoid tip position on frontal radiographs of the shoulder: a predictor of common shoulder pathologies?","volume":"78","author":"C U Schulz","year":"2005","journal-title":"The British Journal of Radiology","ISSN":"https:\/\/id.crossref.org\/issn\/0007-1285","issn-type":"print"},{"issue":"2","key":"ref40","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.jse.2017.09.006","article-title":"Epidemiology of glenohumeral dislocation and subsequent instability in an urban population","volume":"27","author":"David W. Shields","year":"2018","journal-title":"Journal of Shoulder and Elbow Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/1058-2746","issn-type":"print"},{"issue":"8","key":"ref41","doi-asserted-by":"publisher","first-page":"2454","DOI":"10.1007\/s00167-018-4924-4","article-title":"Male gender and age range 20\u201329 years are the most important non-modifiable risk factors for recurrence after primary post-traumatic shoulder dislocation","volume":"26","author":"Karol Szyluk","year":"2018","journal-title":"Knee Surgery, Sports Traumatology, Arthroscopy","ISSN":"https:\/\/id.crossref.org\/issn\/0942-2056","issn-type":"print"},{"issue":"1","key":"ref42","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.arthro.2019.07.008","article-title":"Epidemiology of shoulder instability injuries in collision collegiate sports from 2009 to 2014","volume":"36","author":"Jeffrey D. Trojan","year":"2020","journal-title":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0749-8063","issn-type":"print"},{"issue":"6","key":"ref43","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/bf00180449","article-title":"The rate of recurrence of traumatic anterior dislocation of the shoulder. A study of 154 cases and a review of the literature","volume":"17","author":"J. Vermeiren","year":"1993","journal-title":"International Orthopaedics","ISSN":"https:\/\/id.crossref.org\/issn\/0341-2695","issn-type":"print"},{"issue":"3","key":"ref44","doi-asserted-by":"publisher","first-page":"542","DOI":"10.2106\/jbjs.i.00450","article-title":"Epidemiology of shoulder dislocations presenting to emergency departments in the United States","volume":"92","author":"Michael A Zacchilli","year":"2010","journal-title":"The Journal of Bone and Joint Surgery-American Volume","ISSN":"https:\/\/id.crossref.org\/issn\/0021-9355","issn-type":"print"},{"issue":"4","key":"ref45","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s002560050594","article-title":"Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability","volume":"29","author":"Dominik Weishaupt","year":"2000","journal-title":"Skeletal Radiology","ISSN":"https:\/\/id.crossref.org\/issn\/0364-2348","issn-type":"print"},{"issue":"3","key":"ref46","doi-asserted-by":"publisher","first-page":"2325967120986139","DOI":"10.1177\/2325967120986139","article-title":"Increased glenoid index as a risk factor for pediatric and adolescent anterior glenohumeral dislocation: An MRI-based, case-control study","volume":"9","author":"Joseph L. Yellin","year":"2021","journal-title":"Orthopaedic Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/2325-9671","issn-type":"print"},{"issue":"1","key":"ref47","first-page":"115","article-title":"Clinical assessment of hypermobility of joints: assembling criteria","volume":"19","author":"A. Bulbena","year":"1992","journal-title":"J Rheumatol"},{"key":"ref48","article-title":"The Johns Hopkins ACG Case-Mix System Version 6.0 Release Notes","year":"2003"},{"issue":"6","key":"ref49","doi-asserted-by":"publisher","first-page":"577","DOI":"10.7205\/milmed-d-15-00245","article-title":"Incidence and characteristics of traumatic shoulder instability in Japanese military cadets","volume":"181","author":"Masatoshi Amako","year":"2016","journal-title":"Military Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0026-4075","issn-type":"print"},{"issue":"7","key":"ref50","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.injury.2018.05.013","article-title":"Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population","volume":"49","author":"Martine Enger","year":"2018","journal-title":"Injury","ISSN":"https:\/\/id.crossref.org\/issn\/0020-1383","issn-type":"print"},{"issue":"12","key":"ref51","doi-asserted-by":"publisher","first-page":"3222","DOI":"10.1177\/0363546516660076","article-title":"Critical findings on magnetic resonance arthrograms in posterior shoulder instability compared with an age-matched controlled cohort","volume":"44","author":"Joseph W. Galvin","year":"2016","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"},{"issue":"5","key":"ref52","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/j.jse.2018.09.014","article-title":"Risk factors for anterior shoulder instability: a matched case-control study","volume":"28","author":"Jianqiao Hong","year":"2019","journal-title":"Journal of Shoulder and Elbow Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/1058-2746","issn-type":"print"},{"issue":"14","key":"ref53","doi-asserted-by":"publisher","first-page":"3315","DOI":"10.1177\/0363546517725067","article-title":"Epidemiology of posterior glenohumeral instability in a young athletic population","volume":"45","author":"Joseph T., Jr. Lanzi","year":"2017","journal-title":"The American Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0363-5465","issn-type":"print"}],"container-title":["International Journal of Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/116278-risk-factors-associated-with-first-time-and-recurrent-shoulder-instability-a-systematic-review","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:49:22Z","timestamp":1790174962000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/116278-risk-factors-associated-with-first-time-and-recurrent-shoulder-instability-a-systematic-review"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":53,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.26603\/001c.116278","relation":{},"ISSN":["2159-2896"],"issn-type":[{"value":"2159-2896","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}