Arthroscopy for Acute Shoulder Dislocation

In this study, orthopedic surgeons compare the results of using arthroscopic surgery to repair acute versus chronic shoulder dislocations. All patients dislocated the shoulder during trauma and ended up with a bony Bankart lesion.

A Bankart lesion means there is a fracture of the rim around the shoulder socket. A piece of bone attached to the cartilage pulls away. The result is usually an unstable shoulder joint that dislocates over and over.

With each dislocation, there is tissue trauma. Changes occur in the bone, capsule, and ligaments. This makes healing more difficult. Without surgery to repair the damage, athletes involved in various sports are at risk for redislocation.

Group A had an arthroscopic repair within the first three months after injury. Most of the patients in group A had a single dislocation. A few had up to three redislocations.

Group B were also treated with an arthroscopic repair but the surgery wasn't done until much later. By then, most of the patients had three or more redislocations. One-fourth of the group had up to nine dislocations.

The results of this study suggest that arthroscopic treatment of acute Bankart lesions should be performed in the first three months. Traumatic shoulder injury that went untreated into the chronic phase had worse results when repaired later. They had less motion and decreased function. Fewer were able to return to sports at all. Those who did play participated at a lower level than before the injury.

Arthroscopic surgery for this type of repair is less invasive than open surgery. There is less soft tissue damage and a faster recovery time. The scope has a tiny TV camera on the end that sends the image to a computer screen. The repair can be done under direct vision. With clear access to the surgery site, the surgeon can restore the joint surface closer to the normal anatomy.