Editorial Commentary: Leveraging the Literature: What Can a Half-Century's Worth of Studies Tell Us About Recurrent Instability Following Primary Shoulder Dislocation?

Abstract

A benefit of systematic review (SR) research methods is that well-performed reviews allow authors and readers to identify weaknesses and variability in the orthopaedic literature. An SR on the topic of recurrence rates after conservative treatment of first-time shoulder dislocation provides an excellent example. The example reviews studies covering more than one-half century of time and employing varying methodological designs; the results include estimates of recurrence of shoulder dislocation ranging widely (from 4% to 94.5%). These methods and results raise concerns over the comparability of the studies included in the review. Fortunately, the authors are careful in their use of these data. Although there is little doubt that the review includes a heterogeneous group of articles (and patients), there is value in knowing that much of the variability in the reported rate of recurrence could be related to variations in patient age. Future research, building on more than 50 years of study, would be wise to consider the rate of recurrence among specific age groups. This seems a worthy finding and demonstrates the value of SR methods and the importance of critical analysis of research data.