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Are patients suffering with shoulder dislocations best treated with shoulder surgery or physiotherapy

A new study led by Professor Jonathan Rees, NDORMS will look into the benefits of shoulder surgery following first time traumatic dislocation of the shoulder compared to non-operative treatments such as physiotherapy in preventing further problems.

Professor Rees says: "We are delighted to have won this commissioned award from the HTA and look forward to answering this important UK shoulder healthcare question. The results of this study will provide very useful evidence and information to doctors treating this condition and to patients suffering with it."

Traumatic anterior shoulder dislocations are the most common form of joint dislocations seen in hospital A+E departments however there is still debate on the best treatment to take after the first incident.

In this form of dislocation, the humeral head (top end of the arm bone at the shoulder) is forced out of the shoulder socket frontwards. This can happen after sport injuries or falls and is most common in younger patients. The injury is very painful and the shoulder often stays dislocated until it is reduced or put back in hospital.

In addition to causing a lot of pain, stress and disability, this type of injury often causes the joint to remain unstable and more dislocations can occur. Due to the risk of further dislocations, surgery has become more common as a treatment, but it is still not known which patients are best treated with physiotherapy and which patients are best treated first with surgery.

The UK TASH-D (Treatment of first-time traumatic Anterior SHoulder Dislocation) team will be using information that is already available within the NHS on young patients aged 16-35 years who suffer with traumatic shoulder dislocations to determine whether shoulder surgery is better than non-operative treatments.

The study will also identify risk factors for re-dislocation such as occupation or sport that may influence the type of treatment.

UK TASH-D is funded by the NIHR Health Technology Assessment programme, with HTA Project Reference 14/160/01.