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Investigators find a 2.8% incidence of shoulder instability in cadet population

Nearly 85% of instabilities were subluxations and more than half of these were recurrent events.

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CALGARY, Alberta — College-aged military cadets have an almost 3% incidence of new episodes of traumatic shoulder instability annually, according to findings from a prospective study presented here.

"Shoulder instability is a common entity found in our series of young athletes," Brett D. Owens, MD, first author of the study, said at the American Orthopaedic Society for Sports Medicine 2007 Annual Meeting. "Subluxation events, we think, are extremely common. In comparison, we have seen relatively little information in the literature and it deserves further study."

Owens and colleagues followed 4,141 cadets at West Point Military Academy over 8 months, recording all new occurrences of traumatic shoulder instability. During the study period — from September 2004 to May 2005 — 117 cadets experienced such events, yielding a 2.8% annual incidence rate of traumatic shoulder instability, according to the study.

These 117 cadets averaged 20 years of age; 101 were men (86.3%) and 16 were women (13.7%). Also, 11 cadets experienced multiple instability events.

Overall, 99 events (84.6%) involved subluxations, of which 45 (45.5%) were primary events and 54 (54.5%) were recurrent. The other 18 events (15.4%) involved dislocations — 12 (66.7%) primary dislocations and three (33.3%) recurrent, according to the study.

Most of the instability events — 80.3% — were anterior in nature, 12 (10.3%) were posterior and 11 (9.4%) were multi-directional.

Contact injuries caused 43.6% of all events. Noncontact injuries caused 41% of the instability events, including nine subluxations resulting from missed punches during boxing, the authors reported.

For more information:

• Brett D. Owens, MD, can be reached at Keller Army Hospital, West Point, NY 10996; (845)938-6611.
• Owens BD, Duffey M, Nelson B, et al. The epidemiology of shoulder instability in a young, athletic population. Presented at the American Orthopaedic Society for Sports Medicine 2007 Annual Meeting. July 12-15, 2007. Calgary, Alberta.