title: Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents.
abstract: BACKGROUND
  Conservative treatment of posttraumatic antero-inferior shoulder instability leads to a high failure rate in a young and active population. However, treatment in an adolescent age group is not well documented.
  
  
  METHODS
  We conducted a prospective study with adolescent patients (age 15 to 18 y) who suffered a first traumatic anterior dislocation of the shoulder. Two groups of patients were formed. The first group was treated with early arthroscopic stabilization and the second was treated conservatively. There were 43 shoulders in the operative group and 29 shoulders in the conservative group. The rehabilitation protocol was the same for both groups. All patients were followed up prospectively after 12, 24, and 36 months using Rowe Score.
  
  
  RESULTS
  A total of 38 shoulders in the surgical group and 27 shoulders in the conservative group could be completely evaluated. From the conservative group, 19 patients (70.3%) suffered a recurrence of the instability. From the arthroscopic group, 5 patients (13.1%) suffered a recurrence of the instability.
  
  
  CONCLUSIONS
  In an adolescent population (15 to 18 y), conservative treatment after first traumatic shoulder dislocation including immobilization in internal rotation leads to a significantly higher and unacceptable high failure rate compared with early arthroscopic stabilization.
  
  
  METHODS
  Level II-prospective comparative study.
authors.affiliation: *2nd Orthopaedic Department, Aristotle University of Thessaloniki, Thessaloniki, Greece †Center for Orthopedics and Traumatology, St Anna Hospital Herne, University of Witten/Herdecke, Herne, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Gigis
authors.forename: Roderich
authors.initials: R
authors.lastname: Heikenfeld
authors.forename: Arion
authors.initials: A
authors.lastname: Kapinas
authors.forename: Rico
authors.initials: R
authors.lastname: Listringhaus
authors.forename: Georgios
authors.initials: G
authors.lastname: Godolias
mesh_terms: D000293:Adolescent; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D007593:Joint Instability / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D055502:Secondary Prevention; D012783:Shoulder Dislocation / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D017211:Treatment Failure; D057832:Watchful Waiting