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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1188-1196.
doi: 10.1302/0301-620X.89B9.18467  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Is arthroscopic surgery for stabilisation of chronic shoulder instability as effective as open surgery?

A SYSTEMATIC REVIEW AND META-ANALYSIS OF 62 STUDIES INCLUDING 3044 ARTHROSCOPIC OPERATIONS

J. Hobby, MD, FRCS(Trauma & Orth), Consultant Orthopaedic Surgeon1; D. Griffin, MPhil FRCS(Trauma & Orth), Professor of Trauma and Orthopaedic Surgery2; M. Dunbar, MRCS, Research Fellow in Trauma and Orthopaedic Surgery2; and P. Boileau, MD, Professor and Chairman3

1 North Hampshire Hospitals, NHS Trust, Aldermaston Road, Basingstoke, Hampshire RG24, 9NA, UK.
2 Warwick Medical School, Clinical Sciences Research Institute, Clifford Bridge Road, Coventry CV2 2DX, UK.
3 Orthopaedic Department, Hôpital de l’Archet, 151 Route, de St Antoine, de Ginestière, 06200 Nice, France.

Correspondence should be sent to Professor P. Boileau; e-mail: boileau.p{at}chu-nice.fr

A systematic search of the literature published between January 1985 and February 2006 identified 62 studies which reported the results of arthroscopic procedures for chronic anterior shoulder instability or comparisons between arthroscopic and open surgery. These studies were classified by surgical technique and research methodology, and when appropriate, were included in a meta-analysis.

The failure rate of arthroscopic shoulder stabilisation using staples or transglenoid suture techniques appeared to be significantly higher than that of either open surgery or arthroscopic stabilisation using suture anchors or bio-absorbable tacks. Arthroscopic anterior stabilisation using the most effective techniques has a similar rate of failure to open stabilisation after two years.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General