Arthroscopic transglenoid suture repair for initial anterior shoulder dislocation

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopy

Background:

• Initial anterior shoulder dislocation often affects young, athletic individuals.
• Conservative treatment for such injuries can lead to high recurrence rates, up to 90% in active patients.
• Arthroscopic stabilization techniques aim to restore shoulder stability and function.

Purpose of the Study:

• To evaluate the long-term outcomes of arthroscopic transglenoid suture repair for primary anterior shoulder dislocations.
• To assess the efficacy of this surgical technique in young, active patients with a history of traumatic dislocation.
• To compare the results with those of conservative management.

Main Methods:

• A cohort of 72 patients (61 men, 11 women) with traumatic first-time anterior shoulder dislocation underwent arthroscopic transglenoid suture repair between 1988 and 1995.
• Surgical technique evolved from a single to a double drill hole (3 and 5 o'clock positions).
• Postoperative management included 4 weeks of immobilization followed by physiotherapy, avoiding rotation for 3 weeks.

Main Results:

• At a median follow-up of 66 months, 67 patients (93%) achieved an average Carter-Rowe score of 91.3 points.
• Bankart lesions were identified in 34.7% of cases, and capsulolabral avulsions with labral tears in 60% of cases.
• Redislocation occurred in 6.9% of patients, primarily those with Bankart lesions and associated labral tears; 85% of patients returned to full sporting activity.

Conclusions:

• Arthroscopic transglenoid suture repair demonstrates high efficiency for initial anterior shoulder dislocation in athletic individuals.
• The procedure leads to good long-term functional outcomes and a high rate of return to sport.
• Surgical stabilization is superior to conservative therapy, which is associated with significantly higher recurrence rates.