The purpose of this study was to compare the results of conservative or arthroscopic treatment of first time traumatic anterior-inferior shoulder dislocation in adolescents. Does arthroscopic stabilization lead to a lower recurrence rate than conservative treatment in this group of patients?
33 patients aged between 15 and 18 years who had a first time traumatic anterior-inferior dislocation of their shoulder were suggested for arthroscopic stabilization. MRI proved damage of the anterior-inferior capsule-labrum complex (Bankart lesion) in all cases. In 18 cases the patients and their parents agreed to surgical treatment and were treated with an arthroscopic stabilization of the capsule-labrum complex with absorbable suture anchors. 15 patients who denied the surgical procedure obtained conservative treatment using a sling in the initial posttraumatic phase. Patients were followed prospectively after 12, 24 and 36 months using the Rowe score. A redislocation during follow up was rated as a failure of the treatment.
30 shoulders were completely evaluated, 16 in the arthroscopic and 14 in the conservative group. There were 3 redislocations in the arthroscopic group (1 with adequate trauma, 2 without trauma). 10 shoulders in the conservative group had an redislocation. Rowe Score in the arthroscopic group increased from 58 preop to 86, 88 and 89 at last follow up, in the conservative from 59 to 85, 86 and 88 respectively. 16/18 patients of the surgical group rated their result as good or excellent compared to 5 in the conservative group.
We found a lower rate of recurrence rate and a higher patient satisfaction by arthroscopic treatment. The crucial point might be the anatomical reconstruction of the damaged anterior-inferior capsule-labrum complex. Nevertheless in this young group of patients the recurrence rate after arthroscopic stabilization is higher compared to adult patients.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.