Is arthroscopic surgery for stabilisation of chronic shoulder instability as effective as open surgery?

Abstract

A systematic search of the literature published between January 1985 and February 2006 identified 62 studies which reported the results of arthroscopic procedures for chronic anterior shoulder instability or comparisons between arthroscopic and open surgery. These studies were classified by surgical technique and research methodology, and when appropriate, were included in a meta-analysis. The failure rate of arthroscopic shoulder stabilisation using staples or transglenoid suture techniques appeared to be significantly higher than that of either open surgery or arthroscopic stabilisation using suture anchors or bio-absorbable tacks. Arthroscopic anterior stabilisation using the most effective techniques has a similar rate of failure to open stabilisation after two years.

Long-term result after traumatic anterior shoulder dislocation: what works best?

“…However, some problems have been described concerning the loss of external rotation after open surgery [35]. It is now recognized that limitation of external rotation after repair for anterior instability is a factor predisposing to capsulorrhaphy arthropathy [36].…”

“…These two techniques have been abandoned [35]. Hobby et al [35] reviewed 19 articles who described the use of suture anchors. They had combined failure rate of 8.9%.…”

“…Several review studies have proven statistically that both open and arthroscopic techniques (open or arthroscopic) are equally in managing traumatic anterior glenohumeral instability [23,35,37,38].…”

Traumatic Anterior Shoulder Instability: Part I. General Concepts and Proper Management

“…While the short-term outcome has been excellent, midterm reported results show higher rates of recurrent of instability. According to the meta-analysis by Hobby et al [ 91 ], recurrence (dislocation and subluxation) after arthroscopic Bankart repair with suture anchors varies between 0 and 29.6 %, with a mean of 8.9 %. This rate of course varies with patient factors, particularly the amount of bony defi ciency [ 25 , 71 ].…”

Evaluation and treatment of failed shoulder instability procedures

“…Traditionally, open repair has been the gold standard for stabilization; however, with newer methods and implants, arthroscopic repair is now preferred. Numerous studies over the past decade have shown equivalent outcomes between these two modalities [2]. …”