The shoulder is the most commonly dislocated joint in the body. This injury often results from direct contact with another player, the playing surface, or equipment. A shoulder dislocation can also occur by an indirect mechanism in which the athlete falls on an elbow or outstretched hand. The injured athlete often reports immediate pain and inability to use the affected shoulder. The proper management of a shoulder dislocation after initial reduction is important to decrease pain, restore function, and prevent future recurrence.

The incidence of shoulder dislocation (primary and recurrent) in the United States has been estimated to be between 23.9 and 26.9 per 100,000 person-years. 2,3 Previous studies have been published on initial shoulder dislocation, but they are relatively small, and not focused on high-level elite athletes. 4,5,6 To our knowledge, no study has evaluated the epidemiology of shoulder dislocation among national collegiate athletic association (NCAA) athletes.

A population-based epidemiological study is needed to understand the injury prevalence, mechanisms of injury, and recovery patterns in NCAA student-athletes. We expect the study to find a higher rate of shoulder dislocation among high contact sports such as football, ice hockey, and wrestling. We also expect to see a high rate of recurrence in athletes participating in high contact sports who are treated conservatively (no surgery). This study will aid clinicians when discussing with athletes there risk for shoulder dislocation and their risk for potential recurrence. Hopefully this study will propel further future research to focus on identifying potential risk factors for shoulder dislocation in high risk sports in order to develop injury prevention strategies.

1) Determine the rates and distributions of shoulder dislocations sustained during collegiate sports.

2) Determine the distribution of injuries by mechanism of injury, examine rate of recurrence, rate of injury requiring surgery, and calculate those injuries resulting in time loss over 3 weeks.

3) Compare overall, competition, and practice shoulder dislocation rates between male and female athletes.

4) Examine sex differences in the distributions of mechanism of injury, recurrence, requiring surgery, and those resulting in participation restriction over 3 weeks.

We plan to use the NCAA ISP dataset from 25 NCAA sports to evaluate the epidemiology of shoulder dislocations among high-level elite athletes.

1) Data will be analyzed to assess the rates and distributions of shoulder dislocations sustained during collegiate sports. We will determine the rate of shoulder dislocation overall, by event type, and by time in season.

2) We will next determine the distribution of injuries by mechanism of injury, examine rate of recurrence, rate of injury requiring surgery, and calculate those injuries resulting in time loss over 3 weeks. Rate ratios (RRs) will be used to compare rates within sports by event type (ie, competition and practice).

3) The RRs will also be used to compare overall, competition, and practice rates between male and female athletes in sexcomparable sports.

4) For sex-comparable sports, we will also use injury proportion ratios (IPR) to examine sex differences in the distributions of mechanism of injury, recurrence, requiring surgery, and those resulting in participation restriction over 3 weeks.

STATA

Orthopaedic weekly grand rounds; orthopaedic daily morning didactics and radiology conferences; shoulder/upper extremity weekly conferences; sports medicine weekly conferences.