Comparison of arthroscopic treatment with conservative treatment for acute first-time traumatic anterior shoulder dislocation in a high-demand population

Abstract

Abstract Purpose To compare the outcome of primary arthroscopic stabilization with that of nonoperative treatment for acute first-time traumatic anterior shoulder dislocation in a highly active military population at 5- to 7-year follow-up. Methods The patients in this prospective, nonrandomized study comprised 64 highly active military personnel with a first episode of traumatic anterior shoulder dislocation that occurred during the period January 2001 to July 2004. The patients were offered an arthroscopic procedure or nonoperative treatment. The average age was 22 years (range, 17–29 years). A total of 25 patients were treated by nonoperative methods and 39 patients underwent acute arthroscopic repair with metallic suture anchor fixation. Outcome was evaluated based on the Western Ontario Shoulder Instability Index score, the Disabilities of the Arm, Shoulder and Hand score, range of motion, and return to active duty. The mean follow-up was 71 months (range, 60–84 months). Results In the nonoperative group, 92% suffered a redislocation between 5 and 18 months (average, 10 months). In the operative group, only two patients (5.1%) suffered a redislocation 1 year after surgery. There were no surgical complications. In addition, there was no statistical difference in range of motion of injured sites between the two groups. Conclusions Primary arthroscopic stabilization leads to a significantly lower rate of recurrence of shoulder dislocations than nonoperative treatment in high-demand populations. In addition, there is no significant difference of recurrence rate and functional outcome between the surgical group and the nonoperative groups with recurrent dislocation undergoing arthroscopic stabilization at the final follow up.