Angelo De Carli1, Antonio Pasquale Vadalà2, Riccardo Lanzetti2, Domenico Lupariello2, Edoardo Gaj2, Guglielmo Ottaviani2, Bhavik H Patel3, Yining Lu3, Andrea Ferretti2. 1. Orthopaedic unit and Kirk Kilgour Sports injury Center, S. Andrea Hospital, University of Rome " Sapienza", Via di Grottarossa 1035-1039, 00189, Rome, Italy. angelo.decarli@gmail.com. 2. Orthopaedic unit and Kirk Kilgour Sports injury Center, S. Andrea Hospital, University of Rome " Sapienza", Via di Grottarossa 1035-1039, 00189, Rome, Italy. 3. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
Abstract
PURPOSE: To compare the long-term effectiveness of non-operative treatment with immediate arthroscopic surgical stabilization in young, active patients after first-time anterior glenohumeral dislocation. MATERIALS AND METHODS: Consecutive patients aged 15-25 years who suffered primary traumatic anterior glenohumeral dislocation were enrolled in this prospective, non-randomized investigation. In total, 160 patients were enrolled-64 opted for surgical stabilization (group A), while 96 opted for conservative treatment (group B). At final follow-up of over 6.5 years, 60 patients in group A (96.7% males, age 22.8 ± 3.2) and 70 patients in group B (90.0% males, age 20.8 ± 2.9) were evaluated with physical examination, patient-reported outcome measures (PROMs), and radiological studies. Recurrence and return to sport (RTS) data were collected, and variables were compared between groups. RESULTS: Recurrence rate in group A was 13.3% at mean latency of 3.3 ± 1.9 years, compared to 71.4% at mean latency of 2.1 ± 1.5 years in group B (P < 0.001 for both recurrence rate and latency). In group A, 70.0% of patients RTS at the pre-injury level, versus 41.4% of patients in group B (P < 0.001). Patients in group A scored significantly higher on all PROMs (all P < 0.001) and had significantly less osteoarthritis (P = 0.004), when compared to group B. CONCLUSION: Acute surgical stabilization of first-time anterior shoulder dislocation in young, active patients is more effective than conservative treatment at long-term follow up, based on lower recurrence rate, better RTS, and higher patient-perceived improvement.
PURPOSE: To compare the long-term effectiveness of non-operative treatment with immediate arthroscopic surgical stabilization in young, active patients after first-time anterior glenohumeral dislocation. MATERIALS AND METHODS: Consecutive patients aged 15-25 years who suffered primary traumatic anterior glenohumeral dislocation were enrolled in this prospective, non-randomized investigation. In total, 160 patients were enrolled-64 opted for surgical stabilization (group A), while 96 opted for conservative treatment (group B). At final follow-up of over 6.5 years, 60 patients in group A (96.7% males, age 22.8 ± 3.2) and 70 patients in group B (90.0% males, age 20.8 ± 2.9) were evaluated with physical examination, patient-reported outcome measures (PROMs), and radiological studies. Recurrence and return to sport (RTS) data were collected, and variables were compared between groups. RESULTS: Recurrence rate in group A was 13.3% at mean latency of 3.3 ± 1.9 years, compared to 71.4% at mean latency of 2.1 ± 1.5 years in group B (P < 0.001 for both recurrence rate and latency). In group A, 70.0% of patients RTS at the pre-injury level, versus 41.4% of patients in group B (P < 0.001). Patients in group A scored significantly higher on all PROMs (all P < 0.001) and had significantly less osteoarthritis (P = 0.004), when compared to group B. CONCLUSION: Acute surgical stabilization of first-time anterior shoulder dislocation in young, active patients is more effective than conservative treatment at long-term follow up, based on lower recurrence rate, better RTS, and higher patient-perceived improvement.
Authors: Johannes E Plath; Tim Saier; Matthias J Feucht; Philipp Minzlaff; Gernot Seppel; Sepp Braun; Daniel Hatch; Andreas B Imhoff Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-03-13 Impact factor: 4.342
Authors: Marvin Minkus; Matthias Königshausen; Stephan Pauly; Dirk Maier; Frieder Mauch; Thomas Stein; Stefan Greiner; Mohamed Moursy; Markus Scheibel Journal: Am J Sports Med Date: 2021-02-17 Impact factor: 7.010