ARTHROSCOPIC STABILIZATION OF THE SHOULDER FOR ACUTE PRIMARY DISLOCATIONS USING A TRANSGLENOID SUTURE TECHNIQUE

Many studies report the results of arthroscopic stabilization for recu rrent shoulder instability, with widely variable recurrence rates; how ever, there are very few reports of the use of these techniques in acu te first-time dislocations. We report the clinical outcomes of 17 pati ents who had arthroscopic stabilization using a transglenoid suture te chnique for acute primary dislocation. The surgery took place between March 1992 and March 1994 and, to date, there has been one recurrent d islocation (6%) and no recurrent subluxation. There were no major comp lications, although a number of patients found the knot tied over the infraspinatus fascia to be uncomfortable until it resorbed. All patien ts examined had normal power and range of motion, and a clinically sta ble shoulder. All 16 patients without recurrence were satisfied with t heir result. Nine patients returned to sports at the same or higher le vel, including such vigorous contact sports as Australian Rules footba ll and rugby. Three patients did not return to the same level of sport ing activity because of lack of confidence in the shoulder or a fear o f dislocation despite no clinical evidence of instability. Five patien ts reported a lack of confidence in the shoulder without clinical evid ence of instability. We suggest that arthroscopic stabilization with t ransglenoid sutures or a suture anchor technique is a reasonable optio n for the athlete with an acute primary shoulder dislocation who wishe s to return to sports.