Recurrence After Anterior Shoulder Stabilization: Two Year Results from the MOON Shoulder Cohort

Brian R. Wolf; Warren R. Dunn; Shannon F. Ortiz; Keith M. Baumgarten; Julie Y. Bishop; Matthew J. Bollier; Jonathan T. Bravman; Robert H. Brophy; James E. Carpenter; Charles L. Cox; Brian T. Feeley; Rachel M. Frank; John A. Grant; Grant L. Jones; John E. Kuhn; Drew A. Lansdown; C.Benjamin Ma; Robert G. Marx; Eric C. McCarty; Bruce S. Miller; Andrew S. Neviaser; Adam J. Seidl; Matthew V. Smith; Rick W. Wright; Alan L. Zhang; Carolyn M. Hettrich; MOON Shoulder Group

doi:10.1016/j.jse.2025.12.002

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Recurrence After Anterior Shoulder Stabilization: Two Year Results from the MOON Shoulder Cohort

Journal article

Peer reviewed

Recurrence After Anterior Shoulder Stabilization: Two Year Results from the MOON Shoulder Cohort

Brian R. Wolf, Warren R. Dunn, Shannon F. Ortiz, Keith M. Baumgarten, Julie Y. Bishop, Matthew J. Bollier, Jonathan T. Bravman, Robert H. Brophy, James E. Carpenter, Charles L. Cox, …

Journal of shoulder and elbow surgery, Vol.35(6), pp.1474-1483

06/2026

DOI: 10.1016/j.jse.2025.12.002

PMID: 41475470

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Abstract

The purpose of this study was to analyze rates of recurrent shoulder instability and subsequent surgery, as well as the risk factors associated with those outcomes, in a large prospective multicenter cohort of patients. Patients undergoing surgery for traumatic or atraumatic anterior shoulder instability were prospectively enrolled. The outcomes of interest were subsequent shoulder dislocation, subluxation, or repeat surgery. Multivariate analyses were performed to specifically analyze patient and surgical factors associated with recurrent instability. 889 of 1040 (85.5%) enrolled patients had two-year follow-up data. At two-year follow-up, 43 (4.8%) patients had undergone subsequent surgery for instability, 77 (8.7%) had a shoulder dislocation and 221 (24.9%) reported a shoulder subluxation. Multivariate analysis demonstrated that younger age (p=0.006), a higher PAS-22 score (p=0.02) and number of preoperative dislocation events (p=0.015) were associated with having recurrent instability while smoking approached significance (p=0.055). Sub-analysis of the 778 primary arthroscopic stabilization patients demonstrated 46 patients (5.9%) suffered a dislocation in two years after surgery. Younger age (p=0.0005), smoking (p=0.015), PAS-22 score (p=0.049) and the number of preoperative dislocations (p=0.020) were patient factors associated with recurrent dislocation. None of the surgical variables, including beach chair versus lateral positioning, and the number or type of anchor used were significant. Revision Surgery (p<0.001), duration of preoperative symptoms (p=0.046) and a higher PAS-22 score (p=0.34) were associated with subjective report of shoulder subluxation. In a very large prospective multicenter cohort, with over 85% follow-up, approximately one third of patients had experienced repeat surgery, recurrent dislocation or reported a subluxation or slipping event. Younger age was the strongest risk factor for recurrence after surgery. Smoking, mental health, and number of preoperative dislocations were identified to increase risk for recurrence in the first two years. None of the surgical variables analyzed, including beach chair versus lateral positioning, were significant. This data can be used to guide surgeons and counsel patients who are undergoing anterior shoulder stabilization surgery.

Age

Dislocations

glenohumeral

Outcomes

Recurrence

Risk Factors

Shoulder Instability

Subluxation

Details

Title: Subtitle: Recurrence After Anterior Shoulder Stabilization: Two Year Results from the MOON Shoulder Cohort
Creators: Brian R. Wolf - University of Iowa
Warren R. Dunn - Texas Orthopedic Hospital
Shannon F. Ortiz - University of Iowa
Keith M. Baumgarten - Orthopedic Institute
Julie Y. Bishop - The Ohio State University
Matthew J. Bollier - University of Iowa
Jonathan T. Bravman - University of Colorado Anschutz Medical Campus
Robert H. Brophy - Washington University in St. Louis
James E. Carpenter - University of Michigan
Charles L. Cox - Vanderbilt University
Brian T. Feeley - University of California, San Francisco
Rachel M. Frank - University of Colorado Denver
John A. Grant - University of Michigan
Grant L. Jones - The Ohio State University
John E. Kuhn - Vanderbilt University
Drew A. Lansdown - University of California, San Francisco
C.Benjamin Ma - University of California, San Francisco
Robert G. Marx - Hospital for Special Surgery
Eric C. McCarty - University of Colorado Anschutz Medical Campus
Bruce S. Miller - University of Michigan
Andrew S. Neviaser - The Ohio State University
Adam J. Seidl - University of Colorado Denver
Matthew V. Smith - Washington University in St. Louis
Rick W. Wright - Vanderbilt University
Alan L. Zhang - University of California, San Francisco
Carolyn M. Hettrich
MOON Shoulder Group
Resource Type: Journal article
Publication Details: Journal of shoulder and elbow surgery, Vol.35(6), pp.1474-1483
DOI: 10.1016/j.jse.2025.12.002
PMID: 41475470
NLM abbreviation: J Shoulder Elbow Surg
ISSN: 1058-2746
eISSN: 1532-6500
Publisher: Elsevier Inc; NEW YORK
Grant note: Orthopaedic Research Education Fund National Center for Advancing Translational Sciences: UL1TR001998 University of Kentucky's PSMRF program
Funding was supported, in part, by research grants from the Orthopaedic Research & Education Fund and by the National Center for Advancing Translational Sciences through grant UL1TR001998, as well as through the University of Kentucky's PSMRF program. The content is solely the re-sponsibility of the authors and does not necessarily re University of Kentuckypresent the official views of the National Institutes of Health or the University of Kentucky.
Language: English
Electronic publication date: 12/29/2025
Date published: 06/2026
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9985113255002771

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