Bottoni, Am J Sports Med 2002 - A Prospective, Randomized Evaluation of Arthroscopic Stabilization versus Nonoperative Treatment in Patients with Acute, Traumatic, First-Time Shoulder Dislocations - Article Summary

A Prospective, Randomized Evaluation of Arthroscopic Stabilization versus Nonoperative Treatment in Patients with Acute, Traumatic, First-Time Shoulder Dislocations

Bottoni, Arciero, et al.·Am J Sports Med·2002·457 citations·RCT

Background

Nonoperative treatment of traumatic shoulder dislocations leads to a high rate of recurrent dislocations.

Purpose

Hypothesis: Early arthroscopic treatment for shoulder dislocation will result in a lower recurrence rate than nonoperative treatment.

Methods

Study Design: Prospective, randomized clinical trial.

2 groups of patients were studied to compare nonoperative treatment with arthroscopic Bankart repair for acute, traumatic shoulder dislocations in young athletes.
14 nonoperatively treated patients underwent 4 weeks of immobilization followed by a supervised rehabilitation program.
10 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

3 patients were lost to follow-up.
12 nonoperatively treated patients remained for follow-up.
9 of these (75%) developed recurrent instability.
6 of the 9 have required subsequent open Bankart repair for recurrent instability.
Of the 9 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.

Core

A Prospective, Randomized Evaluation of Arthroscopic Stabilization versus Nonoperative Treatment in Patients with Acute, Traumatic, First-Time Shoulder Dislocations.