Patients with a primary anterior glenohumeral dislocation experience lower rates of recurrent instability with arthroscopic stabilization than with immobilization in external rotation, according to a new study.
“Arthroscopic stabilization has been established as a superior treatment option for primary glenohumeral instability when compared with immobilization in internal rotation. However, immobilization in external rotation has recently gained interest as a viable nonoperative treatment option for patients with shoulder instability,” wrote researchers.
The study, “Immobilization in External Rotation Versus Arthroscopic Stabilization After Primary Anterior Shoulder Dislocation: A Systematic Review of Level 1 and 2 Studies,” was published on March 3, 2023 in The American Journal of Sports Medicine.
In the study, researchers compared the rates of recurrent instability between the two treatment options using a systematic review of current research. They compared rates of recurrent instability, subsequent stabilization surgery, return to sports, positive postintervention apprehension tests and patient-reported outcomes.
Overall, they included 30 studies and 760 patients undergoing arthroscopic stabilization and 409 patients undergoing external immobilization in the Emergency Department in their analysis. The mean age was 23.1 years, and the follow-up time was 55.1 months for the arthroscopy group, and for the external immobilization group, it was a mean age of 29.8 years and a mean follow-up time of 28.8 months.
The researchers found that 8.8% of the arthroscopic stabilization group had recurrent instability at their last follow-up compared with 21.3% of the patients who had external immobilization. Rates of subsequent stabilization procedures were also higher among the external immobilization group (11.3% vs. 5.7%, p = .0015). They also observed that the surgery group had a higher return to sports (p < .05).
Study authors include Andrew G. Potyk, B.S., John W. Belk, B.A., Jonathan T. Bravman, M.D., Adam J. Seidl, M.D., Rachel M. Frank, M.D. and Eric C. McCarty, M.D., all of the University of Colorado School of Medicine in Aurora, Colorado.
