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From the Nirschl Orthopedic & Sports Medicine Clinic, Arlington, Virginia
* Address correspondence to John D. Hubbell, MD, Long Island Bone and Joint, 315 Meeting House Lane, Southampton, NY 11968.
Background: Few long-term studies have compared the efficacy of shoulder stabilization using arthroscopic or open procedures.
Purpose: To directly compare the outcomes of shoulder stabilization using arthroscopic transglenoid sutures versus open capsulolabral repairs.
Study Design: Uncontrolled retrospective review.
Methods: Fifty patients (30 arthroscopic and 20 open) were followed for a minimum of 5 years (mean, 68 months). Pain, motion, strength, function, stability, patient satisfaction, radiographs, and ability to return to preinjury activity levels were evaluated.
Results: The arthroscopic group had a 17% (5 of 30) dislocation rate and a 60% (18 of 30) rate of instability. Sixty-seven percent (6 of 9) of patients participating in collision sports had repeat instability. Eight of 18 patients with instability required open repair for persistent symptoms. There were no limitations of motion following arthroscopic stabilization. The open group had no episodes of dislocations or instability. Forty-five percent (9 of 20) had some loss of external rotation (range, 10°-40°) with a mean loss of 18. The one failure in this group had a 40° loss of external rotation and difficulty with recreational activity. No patients participating in collision sports had repeat instability.
Conclusion: We recommend open stabilization for patients participating in collision sports (for example, football, wrestling) or activities where better stability is required. For those participating in sports where performance may be compromised by loss of external rotation (such as swimming), newer arthroscopic techniques are recommended.
Key Words: shoulder stabilization • capsulolabral repair • shoulder • arthroscopy • dislocation
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