Question:I'm a semi-pro golfer with a bad shoulder from chronic dislocations. The surgeon has offered to do a stabilization procedure with either an open incision or arthroscopically. Is there much difference between these two operations?
Answer:Improvements in both surgical procedures has narrowed the gap of advantages of one over the other. The arthroscopic approach uses two or three puncture wounds to insert a long, thin scope into the joint. It has been suggested that this approach has a more pleasing appearance and shorter operative and recovery time.
The incision approach uses a fairly small open incision to access the joint. The main difference is that the subscapularis muscle is split during the open surgery. Some surgeons feel this puts the patient at a strength disadvantage.
To check out this theory, a team of surgeons and sport medicine staff from Canada put it to the test. They compared before and after muscle strength of the shoulder for an equal number of patients treated arthroscopically versus with an open incision.
They were surprised to find out that patients in both groups had significant strength deficits. External rotation was affected more than internal rotation for both groups. But there wasn't a discernible difference between the two groups. The reason for these two findings remains unknown but a point of interest for future research.Laurie A. Hiemstra, MD, PhD, FRCS(C), et al. Shoulder Strength After Open Versus Arthroscopic Stabilization. In The American Journal of Sports Medicine. May 2008. Vol. 36. No. 5. Pp. 861-867.
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