Comparative study between open and arthroscopic surgical techniques in the management of recurrent anterior instability of the shoulder

Abstract

Background: Present study was done to compare the effectiveness i.e. range of motion and incidence of failure rates, recurrence and pain of arthroscopic repair versus open surgical techniques for the management of recurrent anterior shoulder instability. Materials and Methods: Institution based open-label, comparative clinical study was done at Medical College and Hospital, Kolkata between March 2016 to August 2017 (1.5 years). Based on the result of a similar previous study, a sample size of 15 in each group was calculated. Therefore, 15 cases of anterior shoulder instability treated by arthroscopic method and 15 cases treated by open surgery have been selected for study. Inclusion criteria were patient with soft tissue Bankart’s lesion, bony Bankart’s lesion, humeral avulsion of glenohumeral ligament (HAGL), anterior labral posterior sleeve avulsion (ALPSA), glenoidlabrum and articular disruption and capsular stretch and injury. Study tools were used like Modified Rowe score, ASES (American Shoulder and Elbow Society) score and Goniometer. Operative techniques were used like arthroscopic capsulolabral repair and latarjet procedure. Results: About 14 (93.3%) patients were negative in bony apprehension test in arthroscopic technique. Approximately 15 (93.8%) patients were positive in bony apprehension test in Open technique. Association between bony apprehension test in two groups was not statistically significant (p difference was found between according to CT scan report in two groups (p=0.30910). Mean Rowe pain was significantly higher according in arthroscopic technique compare to open technique at 6W and 9W follow-up period. Mean Rowe stability was significantly higher according in arthroscopic technique compare to open technique at 6W and 9W follow-up period. Conclusion: Both arthroscopic and open surgical methods are utilized for management of anterior glenohumeral instability. The use of arthroscopy has increased significantly in today’s practice an