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Prospective Evaluation of Arthroscopic Stabilization of Acute, Initial Anterior Shoulder Dislocations in Young Athletes

Two- to Five-Year Follow-up

Thomas M. DeBerardino, LTC MC USA, Robert A. Arciero, COL(Ret) MC USA, Dean C. Taylor, LTC MC USA and John M. Uhorchak, COL MC USA

United States Military Academy, Keller Army Hospital, West Point, New York

Presented at the interim meeting of the AOSSM, New Orleans, Louisiana, March 1998 and at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, July 1998.

Address correspondence and reprint requests to LTC Thomas M. DeBerardino, MD, Keller Army Community Hospital, Department of Orthopaedics, 900 Washington Road, West Point, NY 10996-1197

From March 1992 to November 1998, 57 patients sustained 58 acute, initial, traumatic anterior shoulder dislocations at the United States Military Academy. Six patients selected nonoperative treatment. Three patients underwent primary open repair after diagnostic arthroscopy revealed no Bankart lesion amenable to repair with the bioabsorbable tissue tack. The remaining 48 patients with 49 anterior dislocations were treated with arthroscopic primary repair. There were 45 men and 3 women with an average age of 20 years (range, 17 to 23) and an average follow-up of 37 months (range, 24 to 60). The average Rowe score was 92 (range, 30 to 100). The average single assessment numeric evaluation patient rating was 95.5% (range, 50% to 100%). The average Short Form-36 score (physical function) for the stable shoulders was 99 (range, 95 to 100). Forty-three shoulders remained stable (88%). There were six failures (12%). Factors associated with failure included a history of bilateral shoulder instability, a 2+ sulcus sign, and poor capsulolabral tissue at the time of repair. All patients with stable shoulders returned to their preinjury levels of athletic activity. With follow-up of 5 years, we have observed significantly better results compared with nonoperative treatment in young, active adults at the United States Military Academy.

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