Two-year outcome of arthroscopic bankart repair and electrothermal-assisted capsulorrhaphy for recurrent traumatic anterior shoulder instability

Purpose: Arthroscopic treatment of chronic anterior shoulder instability in active athletes is reportedly less successful than open techniques. We per formed arthroscopic stabilization for confirmed capsulolabral avulsions and followed-up patients prospectively for a minimum of 24 months. Type of Stu dy: Prospective nonrandomized study.Methods: We studied 42 patients mean ag e, 26 years) with recurrent traumatic anterior dislocations. They reported an average of 9 dislocations preoperatively. An average of 69 months elapse d from initial dislocation to surgery. The shoulders underwent arthroscopic capsulolabral repair with either a suture anchor and horizontal mattress s uture, or an absorbable tack. Each shoulder also was treated with a monopol ar radiofrequency probe for thermal shrinkage of the middle, anteroinferior , and posteroinferior glenohumeral ligaments. Patients were evaluated prosp ectively for pain, motion, stability, and function using the modified Rowe score. Results: At a mean of 28 months postoperatively, 38 patients had ret urned to their preinjury sports. Three patients (7%) had a traumatic redisl ocation. Using the modified Rowe score, statistically significant improveme nts were noted for pain, stability, and function. There was no significant change in motion. The overall modified Rowe score improved from 38 points p reoperatively to 89 points at final evaluation (P < .001). Conclusions: The se results indicate that arthroscopic treatment of patients with recurrent traumatic anterior instability yields results comparable to open procedures , including athletes involved in high-level contact and collision sports. W e believe that addressing capsular laxity surgically is critical, particula rly when dealing with chronic instability. This procedure allows the surgeo n to reliably correct the labral detachment and the capsular redundancy whi le preserving motion and minimizing morbidity.