Rowe's 1956 retrospective study of 500 shoulder dislocations in 488 patients asks: which patient and injury factors predict recurrence after a first-time dislocation? With mean 4.8-year follow-up on 313 shoulders, it remains the foundational epidemiologic reference for shoulder instability prognosis.
The two numbers every shoulder surgeon carries: 92% recurrence in teenagers, 12% after age 50. Before this paper, the literature on shoulder dislocation prognosis was fragmented — focused on operative techniques rather than who actually redislocates and why.
When a 19-year-old athlete comes in with a first-time anterior dislocation, Rowe's data is why you have a frank conversation about the near-certain recurrence and why early stabilization is on the table. When a 55-year-old comes in with the same injury, the conversation is different: low recurrence risk, but watch for rotator cuff injury.
If you see a Hill-Sachs defect on the post-reduction films, that 82% recurrence figure should shift your counseling. If there's a greater tuberosity fracture, the prognosis is actually better than an isolated dislocation.
This paper also buried the idea that longer slings prevent recurrence. Three weeks may allow tissue healing, but six weeks adds nothing. The Bankart repair's 1.3% failure rate established it as the gold-standard against which every subsequent stabilization procedure is still benchmarked.
Rowe's 1956 retrospective study of 500 shoulder dislocations in 488 patients asks: which patient and injury factors predict recurrence after a first-time dislocation? With mean 4.8-year follow-up on 313 shoulders, it remains the foundational epidemiologic reference for shoulder instability prognosis.
The two numbers every shoulder surgeon carries: 92% recurrence in teenagers, 12% after age 50. Before this paper, the literature on shoulder dislocation prognosis was fragmented — focused on operative techniques rather than who actually redislocates and why.
When a 19-year-old athlete comes in with a first-time anterior dislocation, Rowe's data is why you have a frank conversation about the near-certain recurrence and why early stabilization is on the table. When a 55-year-old comes in with the same injury, the conversation is different: low recurrence risk, but watch for rotator cuff injury.
If you see a Hill-Sachs defect on the post-reduction films, that 82% recurrence figure should shift your counseling. If there's a greater tuberosity fracture, the prognosis is actually better than an isolated dislocation.
This paper also buried the idea that longer slings prevent recurrence. Three weeks may allow tissue healing, but six weeks adds nothing. The Bankart repair's 1.3% failure rate established it as the gold-standard against which every subsequent stabilization procedure is still benchmarked.