Open or Arthroscopic Stabilization of the Shoulder: Does It Matter?Athletes who dislocate their shoulder can develop chronic dislocation. When rehab fails to stabilize the shoulder, then surgery is the treatment of choice. But now there are two ways to do the surgery. Thereâs the traditional open-incision method and the less invasive arthroscopic approach. Which is better?
At first arthroscopic repair of shoulder instability had high rates of failure. Compared to open procedures, arthroscopic surgery was not better. But this may have changed with improved instruments and arthroscopic techniques.
To compare these two surgical methods, two groups of military soldiers with shoulder instability were followed. Half of the patients received an open stabilization. The other half had arthroscopic stabilization. The same surgeon did all operations. The patients in both groups were athletes (military) of equal ages, educational level, and socioeconomic background.
Results were measured by number of failed surgeries, function, motion, and patient satisfaction. The authors report comparable results between the two groups. Differences were seen in blood loss, narcotic use, and hospital stay. All were less for the arthroscopic group. Likewise, the arthroscopic group lost less time from work or training. Patients in the arthroscopic group also had fewer problems after surgery compared to the open group.
The authors advise using the arthroscopic approach for young athletes. Both open and arthroscopic repairs are safe and reliable. Both have equal (low) failure rates. But the arthroscopic method is best for those who want to return to preinjury levels as quickly as possible.
LTC (P) Craig R. Bottoni, MD, et al. Arthroscopic Versus Open Shoulder Stabilization for Recurrent Anterior Instability. In The American Journal of Sports Medicine. November 2006. Vol. 34. No. 11. Pp. 1730-1737.
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