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A prospective, randomized evaluation of arthroscopic stabilization versus nonoperative treatment in patients with
Craig R Bottoni1, John H Wilckens, Thomas M DeBerardino
1Sports Medicine Section, Orthopaedic Surgery Service, Tripler Army Medical Center, Honolulu, Hawaii 96818-4920, USA.
Background:
Nonoperative treatment of traumatic shoulder dislocations leads to a high rate of recurrent dislocations.
Hypothesis:
Early arthroscopic treatment for shoulder dislocation will result in a lower recurrence rate than nonoperative treatment.
Study Design:
Prospective, randomized clinical trial.
Methods:
Two groups of patients were studied to compare nonoperative treatment with arthroscopic Bankart repair for acute, traumatic shoulder dislocations in young athletes. Fourteen nonoperatively treated patients underwent 4 weeks of immobilization followed by a supervised rehabilitation program. Ten operatively treated patients underwent arthroscopic Bankart repair with a bioabsorbable tack followed by the same rehabilitation protocol as the nonoperatively treated patients. The average follow-up was 36 months.
Results:
Three patients were lost to follow-up. Twelve nonoperatively treated patients remained for follow-up. Nine of these (75%) developed recurrent instability. Six of the nine have required subsequent open Bankart repair for recurrent instability. Of the nine operatively treated patients available for follow-up, only one (11.1%) developed recurrent instability.
Conclusions:
Arthroscopic stabilization of traumatic, first-time anterior shoulder dislocations is an effective and safe treatment that significantly reduces the recurrence rate of shoulder dislocations in young athletes when compared with conventional, nonoperative treatment.