Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation infirst traumatic anterior dislocations of the shoulder

Our purpose was to compare the effectiveness of traditional treatment with immediate arthroscopic stabilization in young patients who have sustained a first traumatic anterior dislocation of the shoulder. Forty skeletally mat ure patients younger than 30 years of age were randomly allocated to immobi lization for 3 weeks followed by rehabilitation (group T) or arthroscopic s tabilization (within 4 weeks of injury) followed by an identical immobiliza tion and rehabilitation protocol (group S). A blinded research assistant pe rformed all follow-up evaluations. The dominant arm was involved in 35% of subjects. The injury occurred in a sporting event in 70% of subjects. At 24 months, there was a statistically significant difference in the rate of re dislocation (T = 47%, S = 15.9%, P = .03). An intention-to-treat analysis c omparing disease-specific quality of life using the validated Western Ontar io Shoulder Instability (WOSI) index showed statistically significantly bet ter results in the surgically treated group at the 33 months (T = 633.93 v S = 287.1, P = .03) and no significant difference in range of motion. At an average 32 months follow-up, a significant reduction in redislocation and improvement in disease-specific quality of life is afforded by early arthro scopic stabilization in patients less than 30 year of age with a first, tra umatic, anterior dislocation of the shoulder.