Arthroscopy Has A Good Role In First Time Shoulder Dislocations

Arthroscopic surgery for first-time shoulder dislocation provides long-term benefits for young, athletic patients. This has been revealed in a study conducted in US.

In patients who are young and active, the statistics show that as high as 92 percent of the first time dislocated shoulders would dislocate their shoulder again when treated with traditional non operative measures. The traditional way to treat an acute dislocation of the shoulder is es like rest and immobilization in a sling were used after the shoulder has been dislocated.

Dr. Robert A. Arciero, of the Keller Army Hospital in West Point, N.Y., said in a prepared statement. “If we had an operation with a 90 percent failure rate, we would abandon the procedure. My thought was, why should we embrace a treatment with such a high failure rate?”

In 1993, he began doing arthroscopic surgery on young military cadets who’d suffered their first shoulder dislocation. During the 11.7 years of follow-up, the 39 study participants self-assessed the function of the affected shoulder and also underwent physical testing.

The study found that patients maintained excellent use of the affected shoulder and, on average, reported shoulder function was 93 percent of its pre-injury level of function. The participants’ average number of push ups performed in two minutes was 72.8, compared to 77.7 prior to shoulder dislocation, and the mean score on the Army Physical Fitness Test was 282.2 out of a possible 300.

Five of the patients suffered a total of eight further shoulder dislocations (all during athletic activity), which works out to a long-term failure rate of 10 percent.

“Certainly our study proves that for this group of patients — young, athletic cadets unable to modify their activity level — arthroscopic surgery for first-time dislocations is successful both short and long-term,” Major Dr. Brett Owens, of William Beaumont Army Medical Center in El Paso, Texas, said in a prepared statement.

“This treatment allowed our patients to return to sports, graduate from the military academy, and engage in active duty military obligations. It may not be the approach that should be taken for a person who lives a sedentary lifestyle, but this could be applicable to the young, 15- to 25-year-old athlete who is at high risk for recurrent instability and compromised function,” Owens said.

The study was presented Saturday at the American Orthopaedic Society for Sports Medicine Specialty Day, in San Francisco.

Source:Medline Plus via Health Day

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