ARTHROSCOPIC BANKART REPAIR VERSUS NONOPERATIVE TREATMENT FOR ACUTE, INITIAL ANTERIOR SHOULDER DISLOCATIONS

A prospective study evaluating nonoperative treatment versus arthrosco pic Bankart suture repair for acute, initial dislocation of the should er was undertaken in young athletes. All patients met the following cr iteria: 1) sustained an acute first-time traumatic anterior dislocatio n, 2) no history of impingement or occult subluxation, 3) the dislocat ion required a manual reduction, and 4) no concomitant neurologic inju ry. Thirty-six athletes (average age, 20 years) met the criteria for i nclusion. Group I patients were immobilized for 1 month followed by re habilitation; they were allowed full activity at 4 months. Group II pa tients underwent arthroscopic Bankart repair followed by the same prot ocol as Group I. Group I consisted of 15 athletes. Twelve patients (80 %) developed recurrent instability; 7 of the 12 have required open Ban kart repair for recurrent instability. Group II consisted of 21 patien ts; 18 patients (86%) had no recurrent instability at last followup (a verage, 32 months; range, 15 to 45) (P = 0.001). One patient in Group II has required a subsequent open Bankart repair to treat symptomatic recurrence (P = 0.005). In this study, arthroscopic Bankart repair sig nificantly reduced the recurrence rate in young athletes who sustained an acute, initial anterior dislocation of the shoulder.