This systematic review pooled 39 cohort and case-control studies to identify risk factors for both first-time and recurrent shoulder instability. Unlike prior reviews limited to dislocation, it aimed to cover the full spectrum of instability including subluxation and atraumatic types. The goal was to find modifiable factors that could guide prevention and patient education.
When you counsel a young male athlete after a first shoulder dislocation, the recurrence data should shape the conversation. Age under 30 carried recurrence odds above 20 in the strongest studies, which is why this group is pushed toward earlier stabilization rather than repeated conservative trials.
Look for concomitant injury on top of instability. A rotator cuff tear (OR 10.8) or a posterior bony defect greater than 12mm (OR 32.5) pushes recurrence risk into the large category and argues for surgical planning.
Glenoid morphology matters. A higher glenoid index means a taller, narrower socket with less contact area, so bony anatomy is not just a Bankart-versus-Latarjet detail, it is a baseline instability risk.
Weight this evidence carefully. This is Level III, no meta-analysis was possible, and several key associations rest on single low-quality studies. Use the trends to guide education, not as fixed thresholds.
This systematic review pooled 39 cohort and case-control studies to identify risk factors for both first-time and recurrent shoulder instability. Unlike prior reviews limited to dislocation, it aimed to cover the full spectrum of instability including subluxation and atraumatic types. The goal was to find modifiable factors that could guide prevention and patient education.
When you counsel a young male athlete after a first shoulder dislocation, the recurrence data should shape the conversation. Age under 30 carried recurrence odds above 20 in the strongest studies, which is why this group is pushed toward earlier stabilization rather than repeated conservative trials.
Look for concomitant injury on top of instability. A rotator cuff tear (OR 10.8) or a posterior bony defect greater than 12mm (OR 32.5) pushes recurrence risk into the large category and argues for surgical planning.
Glenoid morphology matters. A higher glenoid index means a taller, narrower socket with less contact area, so bony anatomy is not just a Bankart-versus-Latarjet detail, it is a baseline instability risk.
Weight this evidence carefully. This is Level III, no meta-analysis was possible, and several key associations rest on single low-quality studies. Use the trends to guide education, not as fixed thresholds.