Question:My orthopedic surgeon told me he is going to repair my shoulder "the old fashioned way" with an open incision. Should I look around for someone who will do it some other (more updated) way?
You've just been introduced to the ongoing debate about shoulder repairs. Some surgeons use an open incision. Others use an arthroscope, which eliminates cutting the patient open. There are usually two or three small puncture holes where the arthroscope enters through the skin into the joint.
Some surgeons declare the open method the best and say it has "stood the test of time." Others are more willing to try arthroscopy and compare the two techniques.
Studies show there is a steep learning curve with arthroscopy. This means the surgeon learns how to use this method and improves quickly with each case. There is great variation in ways to do arthroscopic shoulder repair compared with open methods.
This fact alone makes it difficult to compare the techniques. Most researchers use the final results to compare the two methods. You can always ask your surgeon what his results are with the open method and compare this to another surgeon who uses arthroscopy.
Right now both ways are perfectly acceptable with good results.Nicholas G. H. Mohtadi, MD, FRCSC, et al. Arthroscopic Versus Open Repair for Traumatic Anterior Shoulder Instability: A Meta-analysis. In Arthroscopy. June 2005. Vol. 21. No. 6. Pp. 652-658.
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