Incidence of shoulder dislocations in the UK, 1995–2015: a population-based cohort study

Objective This cohort study evaluates the unknown age-specific and gender-specific incidence of primary shoulder dislocations in the UK. Setting UK primary care data from the Clinical Practice Research Datalink (CPRD) were used to identify patients aged 16–70 years with a shoulder dislocation during 1995–2015. Coding of primary shoulder dislocations was validated using the CPRD general practitioner questionnaire service. Participants A cohort of 16 763 patients with shoulder dislocation aged 16–70 years during 1995–2015 were identified. Primary outcome measure Incidence rates per 100 000 person-years and 95% CIs were calculated. Results Correct coding of shoulder dislocation within CPRD was 89% (95% CI 83% to 95%), and confirmation that the dislocation was a ‘primary’ was 76% (95% CI 67% to 85%). Seventy-two percent of shoulder dislocations occurred in men. The overall incidence rate in men was 40.4 per 100 000 person-years (95% CI 40.4 to 40.4), and in women was 15.5 per 100 000 person-years (95% CI 15.5 to 15.5). The highest incidence was observed in men aged 16–20 years (80.5 per 100 000 person-years; 95% CI 80.5 to 80.6). Incidence in women increased with age to a peak of 28.6 per 100 000 person-years among those aged 61–70 years. Conclusions This is the first time the incidence of shoulder dislocations has been studied using primary care data from a national database, and the first time the results for the UK have been produced. While most primary dislocations occurred in young men, an unexpected finding was that the incidence increased in women aged over 50 years, but not in men. The reasons for this are unknown. Further work is commissioned by the National Institute for Health Research to examine treatments and predictors for recurrent shoulder dislocation. Study registration The design of this study was approved by the Independent Scientific Advisory Committee (15_260) for the Medicines & Healthcare products Regulatory Agency.

[1]  H. Hill,et al.  The Grooved Defect of the Humeral Head , 1940 .

[2]  C. Rowe,et al.  Prognosis in dislocations of the shoulder. , 1956, The Journal of bone and joint surgery. American volume.

[3]  J H Henry,et al.  Natural history of glenohumeral dislocation—revisited , 1982, The American journal of sports medicine.

[4]  L. Hovelius,et al.  Incidence of shoulder dislocation in Sweden. , 1982, Clinical orthopaedics and related research.

[5]  L. Melton,et al.  Incidence of anterior shoulder dislocation in Olmsted County, Minnesota. , 1984, Clinical orthopaedics and related research.

[6]  T. P. Goss.  Anterior glenohumeral instability. , 1988, Orthopedics.

[7]  E. Berg.  Anterior Shoulder Dislocation , 1993, Orthopedic nursing.

[8]  A. S. Blundell Bankart,et al.  RECURRENT OR HABITUAL DISLOCATION OF THE SHOULDER-JOINT , 1923, Clinical orthopaedics and related research.

[9]  C. Petersson,et al.  Incidence and causes of shoulder girdle injuries in an urban population. , 1995, Journal of shoulder and elbow surgery.

[10]  C. Milgrom,et al.  A prevalence study of recurrent shoulder dislocations in young adults. , 1998, Journal of shoulder and elbow surgery.

[11]  L Abenhaim,et al.  The use of a large pharmacoepidemiological database to study exposure to oral corticosteroids and risk of fractures: validation of study population and results , 2000, Pharmacoepidemiology and drug safety.

[12]  Tx Station.  Stata Statistical Software: Release 7. , 2001 .

[13]  T. Lind,et al.  The epidemiology of shoulder dislocations , 2004, Archives of Orthopaedic and Trauma Surgery.

[14]  C. Robinson,et al.  Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. , 2006, The Journal of bone and joint surgery. American volume.

[15]  B. Nelson,et al.  The Incidence and Characteristics of Shoulder Instability at the United States Military Academy , 2007, The American journal of sports medicine.

[16]  Bo Tillander,et al.  Nonoperative treatment of primary anterior shoulder dislocation in patients forty years of age and younger. a prospective twenty-five-year follow-up. , 2008, The Journal of bone and joint surgery. American volume.

[17]  L. Smeeth,et al.  How accurate are diagnoses for rheumatoid arthritis and juvenile idiopathic arthritis in the general practice research database? , 2008, Arthritis and rheumatism.

[18]  R. Burks,et al.  Incidence of shoulder dislocation in the United States military: demographic considerations from a high-risk population. , 2009, The Journal of bone and joint surgery. American volume.

[19]  J. Agel,et al.  Incidence of Glenohumeral Instability in Collegiate Athletics , 2009, The American journal of sports medicine.

[20]  S. Cho,et al.  Traumatic Anterior Dislocation of the Shoulder: Factors Affecting the Progress of the Traumatic Anterior Dislocation , 2009, Clinics in orthopedic surgery.

[21]  B. Owens,et al.  Epidemiology of shoulder dislocations presenting to emergency departments in the United States. , 2010, The Journal of bone and joint surgery. American volume.

[22]  Chien-Lung Chan,et al.  Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005 , 2011, BMC musculoskeletal disorders.

[23]  O. Reikerås,et al.  The epidemiology of shoulder dislocations in Oslo , 2011, Scandinavian journal of medicine & science in sports.

[24]  E. J. Pope,et al.  Anterior shoulder instability - a history of arthroscopic treatment. , 2011, Bulletin of the NYU hospital for joint diseases.

[25]  P. Austin,et al.  Epidemiology of Primary Anterior Shoulder Dislocation Requiring Closed Reduction in Ontario, Canada , 2014, The American journal of sports medicine.

[26]  K. Bhaskaran,et al.  Data Resource Profile: Clinical Practice Research Datalink (CPRD) , 2015, International journal of epidemiology.