The role of arthroscopy in chronic anterior shoulder dislocation: technique and early results

Abstract

Dislocation that lasts longer than 3 weeks is called chronic or unreduced shoulder dislocation. Treatment alternatives can be closed reduction, open reduction, resection arthroplasty, prosthesis, arthrodesis, and no therapy. The English-language literature includes no evidence on arthroscopic reduction for the treatment of unreduced shoulder dislocation. The goal of our study was to present our technique and period results on the arthroscopic reduction we performed in 2 cases 4 and 5 weeks after anterior shoulder dislocation. Reduction could not be achieved by closed reduction under anesthesia. With arthroscopic visualization, adhesions within the joint were released with blunt dissection. Repeat reduction attempts were unsuccessful in these 2 cases. Labroligamentous lesions of the inferior glenohumeral ligament were repaired using 3 absorbable tacks. On the second day after the surgery, isometric exercises were started. The results were evaluated using a 100-unit test recommended by Rowe and Zarins (80 units in case 1; 85 units in case 2). Reduction of chronic unreduced shoulder dislocations using arthroscopy is an alternative technique for selected patients. It also allows repair and treatment of the intra-articular pathology in the joint and makes early postoperative rehabilitation possible.