Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation.
OBJECTIVE
To report the long-term results of a prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation after a first traumatic anterior dislocation of the shoulder.


METHODS
Randomized clinical trial.


METHODS
Forty subjects younger than 30 years with a first traumatic anterior shoulder dislocation were randomized to receive immediate anterior stabilization plus rehabilitation or immobilization followed by rehabilitation. Patients completed the American Shoulder and Elbow Surgeons (ASES), Disabilities of the Arm, Shoulder and Hand (DASH), and the Western Ontario Shoulder Instability Index (WOSI) questionnaires.


RESULTS
At an average follow-up of 75 months, there was a significant difference in the rate of redislocation between the groups but no statistical significant difference in shoulder function with the ASES or the DASH. The mean difference between the 2 groups with the WOSI estimates a small, but clinically significant difference.


CONCLUSIONS
It is recommended that immediate arthroscopic stabilization is the treatment of choice in a subset of patients who are younger than 30 years and are higher level athletes, and the timing for surgery is good or their sport is risky, i.e., rugby, football, kayaking, rock climbing.


METHODS
Level II.
Kirkley
Alexandra
A
Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.
Werstine
Robert
R
Ratjek
Andrew
A
Griffin
Sharon
S
D000328:Adult; D001182:Arthroscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D008297:Male; D011446:Prospective Studies; D012783:Shoulder Dislocation / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors