Recurrent post-traumatic anterior shoulder dislocation--open versus arthroscopic repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability

Background:

• Recurrent anterior shoulder dislocation is a common issue following trauma.
• Bankart lesions frequently accompany shoulder dislocations, necessitating surgical repair.
• Previous studies have compared arthroscopic and open Bankart repair, with varying results.

Purpose of the Study:

• To compare the outcomes of arthroscopic Bankart repair with capsular plication versus open Bankart repair using Mitec anchors.
• To evaluate long-term functional and subjective results in patients with recurrent anterior shoulder dislocation.

Main Methods:

• A prospective study of 41 patients with unilateral, isolated, posttraumatic, recurrent anterior shoulder dislocation and a Bankart lesion.
• Patients underwent either arthroscopic repair with capsular plication or open repair with Mitec anchors.
• Follow-up was conducted by a blinded observer at a median of 36 months, assessing laxity, range of motion, and patient-reported outcomes.

Main Results:

• Both groups showed comparable rates of excellent or good results (19 patients each).
• No significant difference in objective anterior-posterior shoulder laxity was found.
• The open repair group experienced significantly longer hospitalization, a decrease in external range of motion, and more cosmetic complaints.

Conclusions:

• Arthroscopic and open Bankart repair techniques yield similar clinical outcomes for recurrent anterior shoulder instability in the long term.
• Open repair is associated with increased hospitalization and aesthetic concerns.
• Both methods are effective in managing longstanding shoulder instability, with patient selection being a key consideration.