Arthroscopic transglenoid suture repair for initial anterior shoulder dislocation

Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation: expected-value decision analysis

“…This finding is consistent with a growing number of studies in the orthopaedic literature showing that primary arthroscopic stabilization reduces rates of recurrent instability. 2,3,5,6,10,15,18,19,25,28,31 This remains, however, a difficult clinical question, and treatment must be individualized to each patient. Important variables in the decision-making process such as patient age or activity level were not directly accounted for in our model.…”

“…Stiffness was defined differently by the various authors reporting on this outcome, with one study describing ''global shoulder stiffness, with severe loss of external rotation'' 25 and another reporting on ''therapy-refractory limitations of movement necessitating mobilization under general anesthesia.'' 5 We used both of these definitions in estimating the probability of stiffness.…”

“…12,17,24,26,27 For this reason, there has been increasing interest in the role of arthroscopic stabilization after primary traumatic anterior dislocation in young active patients, with several authors reporting favorable results. 2,3,5,6,10,14,15,[18][19][20]25,28,31 However, this management strategy exposes patients to the morbidities of surgery and is a significant departure from the more prevalent and wellestablished tradition of nonoperative care. Therefore differences of opinion and uncertainty around patient management persist.…”

Shoulder Instability: Management and Rehabilitation

“…However, arthroscopic procedures are associated with less loss in external rotation than open procedures. Arthroscopic techniques for reattaching the labrum can be divided into three categories: (1) a transglenoid suture technique, 14,26,35,51,62,74,76 (2) arthroscopically delivered and tied suture anchors, 33,40,93 and (3) arthroscopically delivered biodegradable tacs. 4,12,25,26,28,51,52,86,92 A comparison of the reported rates of recurrent dislocation for each technique is made in the Table. Multidirectional Instability The most commonly performed and most successfully reported surgical procedure for multidirectional instability of the shoulder is an anterior capsular shift, an open procedure that involves the overlaying and thus shortening of the anterior and inferior capsule.…”

First-time anterior shoulder dislocations: has the standard changed?

“…Several authors have reported on surgical techniques of acute stabilisation after an initial traumatic shoulder dislocation, ranging from open treatment to arthroscopic repair with transglenoid sutures or anchors to the addition of a capsular shift 50–56. In 2000, Boszotta and Helperstorfer50 reported on the outcomes of 72 traumatic first-time Austrian dislocators who underwent acute arthroscopic transglenoid suture repair.…”