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Comparison of Outcomes of Open Versus Arthroscopic Stabilization of Recurrent Anterior Shoulder Dislocation
Abstract
Objective: To compare the outcomes of open versus arthroscopic Bankart procure for stabilization of recurrent anterior shoulder joint dislocation.
Methodology: A single surgeon randomly assigned 24 consecutive patients with recurrent anterior shoulder instability to either arthroscopic or open stabilization. Prior to surgery, MRI arthrogram tests were acquired. These results were contrasted with arthroscopic results. Range of motion, stability, and subjective evaluations such as the Western Ontario Instability Index and ASES were all part of the postoperative examinations at 2nd and 17th week post-operatively.
Results: 90 participants were eligible. Out of these, 66 were not eligible. Twenty-four (twelve in each group) Prior to meeting their assigned surgeon, patients were randomly assigned to either the arthroscopic or the open surgery group after giving their consent to participate. Independent t-test functional score was mean (and SD) for ASES score open surgery 74.33 ± 2.535, for arthroscopic surgery 92.0 ± 3.162, for, ROWE score open surgery 79.58 ± 4.337 and for arthroscopic surgery 95.50 ± 1.44. There is no significant difference in ASES and ROWE score (p= 0.362) and (p= 0.925). The WOSI scores increased significantly from baseline to 2nd week and 17th week postoperatively within each treatment group
Conclusion: After open and arthroscopic stabilization, the clinical results were comparable. In shoulders with anterior instability, preoperative magnetic resonance arthrograms enable an accurate identification of intra-articular abnormalities that correlates well with surgical results. The clinical results of arthroscopic surgery for recurrent anterior shoulder instability are on par with those following conventional surgical stabilization.
References
O'Reilly OC, Andrews KA, Siparsky PN. Understanding the Glenoid Avulsion of the Glenohumeral Ligaments as a Cause of Shoulder Instability: Surgical and Postsurgical Management. Arthrosc Tech. 2019;8(10):e1153-e8.
Wellmann M, Pastor MF, Ettinger M, Koester K, Smith T. Arthroscopic posterior bone block stabilization-early results of an effective procedure for the recurrent posterior instability. Knee Surg Sports Traumatol Arthrosc. 2018;26(1):292-8.
Qi W, Zhan J, Yan Z, Lin J, Xue X, Pan X. Arthroscopic treatment of posterior instability of the shoulder with an associated reverse Hill-Sachs lesion using an iliac bone-block autograft. Orthop Traumatol Surg Res. 2019;105(5):819-23.
Provencher MT, Midtgaard KS, Owens BD, Tokish JM. Diagnosis and Management of Traumatic Anterior Shoulder Instability. J Am Acad Orthop Surg. 2021;29(2):e51-e61.
Friedman LGM, Lafosse L, Garrigues GE. Global Perspectives on Management of Shoulder Instability: Decision Making and Treatment. Orthop Clin North Am. 2020;51(2):241-58.
Wright MA, Keener JD, Chamberlain AM. Comparison of Clinical Outcomes After Anatomic Total Shoulder Arthroplasty and Reverse Shoulder Arthroplasty in Patients 70 Years and Older With Glenohumeral Osteoarthritis and an Intact Rotator Cuff. J Am Acad Orthop Surg. 2020;28(5):e222-e9.
Domb BG, Chen SL, Shapira J, Maldonado DR, Lall AC, Rosinsky PJ. The Evolution of Hip Arthroscopy: What Has Changed Since 2008-A Single Surgeon's Experience. Arthroscopy. 2020;36(3):761-72.
M N, Pandey RK, Sharma A, Darlong V, Punj J, Sinha R, et al. Pectoral nerve blocks to improve analgesia after breast cancer surgery: A prospective, randomized and controlled trial. J Clin Anesth. 2018;45:12-7.
Pagnani MJ, Dome DC. Surgical treatment of traumatic anterior shoulder instability in american football players. J Bone Joint Surg Am. 2002;84(5):711-5.
Werner BC, McClish SJ, Mealey NC, Wijdicks C, Thompson T, Higgins LD. A biomechanical comparison of subscapularis tenotomy repair techniques for stemless shoulder arthroplasty. J Shoulder Elbow Surg. 2022;31(4):711-7.
DiMaria S, Bokshan SL, Nacca C, Owens B. History of surgical stabilization for posterior shoulder instability. JSES Open Access. 2019;3(4):350-6.
Owens BD, Campbell SE, Cameron KL. Risk Factors for Posterior Shoulder Instability in Young Athletes. The American Journal of Sports Medicine. 2013;41(11):2645-9.
Kohan EM, Wong J, Stroh M, Syed UAM, Namdari S, Lazarus M. Outcome of biceps suspensionplasty for recurrent multidirectional shoulder instability. J Orthop. 2020;22:473-7.
Antunes JP, Mendes A, Prado MH, Moro OP, Miró RL. Arthroscopic Bankart repair for recurrent shoulder instability: A retrospective study of 86 cases. J Orthop. 2016;13(2):95-9.
Karlsson J, Magnusson L, Ejerhed L, Hultenheim I, Lundin O, Kartus J. Comparison of Open and Arthroscopic Stabilization for Recurrent Shoulder Dislocation in Patients with a Bankart Lesion. The American Journal of Sports Medicine. 2001;29(5):538-42.
Mohtadi NGH, Chan DS, Hollinshead RM, Boorman RS, Hiemstra LA, Lo IKY, et al. A Randomized Clinical Trial Comparing Open and Arthroscopic Stabilization for Recurrent Traumatic Anterior Shoulder Instability: Two-Year Follow-up with Disease-Specific Quality-of-Life Outcomes. JBJS. 2014;96(5):353-60.
Skendzel JG, Sekiya JK. Diagnosis and management of humeral head bone loss in shoulder instability. Am J Sports Med. 2012;40(11):2633-44.
Bottoni CR, Smith EL, Berkowitz MJ, Towle RB, Moore JH. Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med. 2006;34(11):1730-7.
Rhee YG, Ha JH, Cho NS. Anterior Shoulder Stabilization in Collision Athletes:Arthroscopic Versus Open Bankart Repair. The American Journal of Sports Medicine. 2006;34(6):979-85.
