Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations.
A prospective study evaluating nonoperative treatment versus arthroscopic Bankart suture repair for acute, initial dislocation of the shoulder was undertaken in young athletes. All patients met the following criteria: 1) sustained an acute first-time traumatic anterior dislocation, 2) no history of impingement or occult subluxation, 3) the dislocation required a manual reduction, and 4) no concomitant neurologic injury. Thirty-six athletes (average age, 20 years) met the criteria for inclusion. Group I patients were immobilized for 1 month followed by rehabilitation; they were allowed full activity at 4 months. Group II patients underwent arthroscopic Bankart repair followed by the same protocol as Group I. Group I consisted of 15 athletes. Twelve patients (80%) developed recurrent instability; 7 of the 12 have required open Bankart repair for recurrent instability. Group II consisted of 21 patients; 18 patients (86%) had no recurrent instability at last followup (average, 32 months; range, 15 to 45) (P = 0.001). One patient in Group II has required a subsequent open Bankart repair to treat symptomatic recurrence (P = 0.005). In this study, arthroscopic Bankart repair significantly reduced the recurrence rate in young athletes who sustained an acute, initial anterior dislocation of the shoulder.
Arciero
R A
RA
Orthopaedic Service, United States Military Academy, West Point, New York.
Wheeler
J H
JH
Ryan
J B
JB
McBride
J T
JT
D000208:Acute Disease; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007103:Immobilization; D007593:Joint Instability / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D012783:Shoulder Dislocation / Q000601:surgery / Q000628:therapy*; D013536:Suture Techniques