We don’t know a millionth of one percent about anything.
Thomas Edison
A recent presentation at the American Arthroscopy Association of North America tried to answer the question of why some adolescents re-dislocate their shoulder and others do not after shoulder instability repair. The researchers could not find any specific reason why some adolescents patients had re-dislocations and others did not.
In this group of 110 patients who had a shoulder instability surgery, 15 of them went on to have a new dislocation.
The authors examined multiple factors that have been shown to be risk factors for re-dislocation in adults such as bone loss however none of them seem to correlate with an increased risk of dislocation in this patient group.
Take-home points:
- Adolescents aren’t exactly the same as adults. We need to keep this in mind when tailoring treatment.
- Perhaps the number of patients in the study was not large enough to detect a real difference. Sometimes studies like this need really large numbers to see a subtle relationship emerge conclusively
- There may be a reason that some patients re-dislocate their shoulders after surgery, but we just don’t totally understand it right now.
We all hate uncertainty but sometimes “I don’t know” is the best answer we have. Better to say that, than to be overly certain about the wrong answer.