Arthroscopy: The Journal of Arthroscopic & Related Surgery
Evidence-Based Medicine Systematic ReviewSystematic ReviewThe Treatment of Traumatic Anterior Instability of the Shoulder: Nonoperative and Surgical Treatment
Section snippets
Methods
We identified all published studies in English addressing the treatment of traumatic anterior shoulder instability. We then focused on inclusion criteria for our 2 areas of interest. First, we identified studies comparing surgical treatment to nonoperative treatment for first-time traumatic anterior shoulder dislocation. We then identified comparisons of open surgical treatment to arthroscopic surgical treatment using suture anchors for anterior shoulder instability. Studies were excluded if
Results
The PubMed search identified 2,494 articles. We identified 6 articles that related to our issue of immediate surgical stabilization versus nonoperative treatment for first-time anterior shoulder dislocation (Table 1). Two of these articles represented the early and late results in the same cohort, and these data were included accordingly.19, 21
We identified 20 articles that compared arthroscopic treatment of anterior shoulder instability with open treatment (Table 2). However, suture anchors
Discussion
Traumatic anterior shoulder instability is a common problem with an accepted treatment algorithm of initial nonsurgical treatment, with surgical stabilization indicated after recurrent instability. Open stabilization is considered the gold standard for surgical treatment of this problem. Our review suggests that early surgical stabilization has the advantage of a significantly lower recurrence rate for young active patients. However, early surgical intervention will result in some patients
Conclusions
Rates of recurrent instability after a first-time anterior shoulder dislocation, particularly in young active male patients, are reduced by surgical intervention compared to nonoperative treatment. If surgical treatment is indicated, an arthroscopic approach using suture anchors appears to have similar results in terms of recurrent instability to an open approach using suture anchors.
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The authors report no conflict of interest.