Format

Send to

Choose Destination
Arthroscopy. 2005 Jun;21(6):652-8.

Arthroscopic versus open repair for traumatic anterior shoulder instability: a meta-analysis.

Author information

1
University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada. mohtadi@ucalgary.ca

Abstract

PURPOSE:

The purpose of this study was to critically evaluate the literature to determine whether open or arthroscopic surgical repair for traumatic recurrent anterior shoulder instability results in a better outcome.

TYPE OF STUDY:

Meta-analysis.

METHODS:

The search involved clinical studies in all languages in the MEDLINE database from 1966 to October 31, 2003. The following key words were used: (1) anterior shoulder instability, (2) Bankart lesion, (3) traumatic recurrent anterior shoulder instability, and (4) arthroscopic and open Bankart repair. All abstracts were reviewed and articles were included if there was a direct clinical comparison between arthroscopic and open repair for traumatic recurrent anterior shoulder instability. These articles were manually cross-referenced for additional abstracts. The final group of articles was independently critically appraised and the following outcomes were extracted: recurrent instability, return to activity, reoperation rate, and cause of recurrence.

RESULTS:

The search terms resulted in 677, 183, 68, and 51 hits respectively. From these, 18 articles were determined to be eligible for full review including 2 foreign-language articles. Cross-referencing identified 2 unpublished studies. Eleven studies were included in the final analysis: 1 randomized trial, 2 pseudo-experimental designs, 4 prospective cohorts, 3 retrospective studies, and 1 case control study. Pooled Mantel-Haenszel odds ratio for recurrent instability and return to activity were 2.04 ( P = .003; 95% confidence interval, 1.27, 3.29) and 2.85 ( P = .004; 95% confidence interval, 1.40, 5.78), respectively, in favor of the open repair.

CONCLUSIONS:

Based on this meta-analysis, open repair has a more favorable outcome with respect to recurrence and return to activity.

LEVEL OF EVIDENCE:

Level III, Systematic Review of Level III (and II/I) Studies.

PMID:
15944618
DOI:
10.1016/j.arthro.2005.02.021
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center