Arthroscopic Bankart Repair Versus Immobilization for a First Episode of an Anterior Shoulder Dislocation Before the Age of 25 Years: A Randomized Controlled Trial With 6-Year Follow-up.

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Study Summary

40 patients between the ages of 18-and-25 years with first episode of an anterior shoulder dislocation (ASD) were randomised to either receive Arthroscopic Bankart Repair (n=20) or immobilization treatment (n=20). The primary outcome of interest was recurrence of instability or another ASD. The secondary outcomes of interest were Disabilities of the Arm, Shoulder and Hand (Quick DASH), Walch-Duplay score, and Western Ontario Shoulder Instability Index (WOSI), return to sport and need for stabilization surgery. The results of the study revealed that at 6-year follow-up, the surgical group had a significantly lower rate of recurrent shoulder instability compared to the nonoperative group. Also, complete dislocations were more frequent in the nonoperative group, and the need for primary or secondary shoulder stabilization surgery was significantly higher in the nonoperative group. Functional outcomes, including Quick DASH and WOSI scores and Walch-Duplay scores for stability, mobility and pain, were significantly better in the surgical group. Lastly, the rate of return to sports was significantly higher in the surgical group compared to the nonoperative group, while there was no significant difference in the incidence of adverse events.