2009 J. A. Nutter Award Recipient
Best Paper Award

GENERALIZED LIGAMENTOUS LAXITY AS A PREDISPOSING FACTOR FOR PRIMARY ANTERIOR SHOULDER DISLOCATION

Jaskarndip Chahal, M.D.
University of Toronto
Toronto, ON 

T. McCarthy
J. Leiter
D. Whelan  

Purpose: 
To determine whether generalized ligamentous laxity is a predisposing factor for primary traumatic anterior shoulder dislocation in young, active patients. 

Methods: 
Prospective case series with age and sex matched controls.  The Hospital Del Mar Criteria was utilized to measure generalized ligamentous laxity.   Fifty-seven (n=57) consecutive individuals (age<30) sustaining a primary traumatic anterior shoulder dislocation between 2003-2006 were examined.  The control group consisted of seventy-two (n=72) undergraduate students without prior history of shoulder dislocation or ACL injury.  

Results: 
After adjusting for age and sex, the prevalence of hyperlaxity in the cases was 32.8% compared with 10.4% in the control group (p 85^o) was 40.3% in the cases compared with 20.8% in the control group (p<0.03).  Among males, the prevalence of hyperlaxity was 28.3% in the study group and 5.3% in the controls (p<0.01).  

Conclusions: 
Generalized joint laxity and increased external rotation in the contralateral shoulder were more common in patients who had sustained a primary shoulder dislocation. This may suggest a role for shoulder-specific proprioceptive and strength training protocols in hyperlax individuals participating in high-risk sports.  The implications of hyperlaxity on the surgical management of traumatic primary shoulder instability are uncertain.