Arthroscopic Versus Open Stabilization for Traumatic Shoulder Instability

Summary

The purpose of this study is to compare arthroscopic and open shoulder stabilization procedures by measuring the disease-specific quality of life outcome in patients with traumatic unidirectional anterior instability of the shoulder at 2 and 5 years.

Hypothesis: There is no difference in disease-specific quality of life outcomes in patients with traumatic unidirectional anterior shoulder instability, undergoing an arthroscopic versus an open stabilization procedure.

Conditions

• Joint Instability
• Shoulder Dislocation

Interventions

PROCEDURE

Open stabilization

Following examination under anesthesia, a 5cm standard deltopectoral incision is made. Dissection is continued exploiting the deltopectoral internervous plane. The conjoined tendon is retracted medially. The underlying subscapularis tendon is identified and incised horizontally or split vertically in its midsubstance. If required for adequate exposure, the subscapularis split may be extended by incising the inferior component of the subscapularis tendon near its insertion on the lesser tuberosity. The shoulder is entered by performing a "T" shaped arthrotomy with retractors for full exposure of the glenoid. Shoulder pathology is addressed with suture anchor repair of any capsulolabral detachment (ie.Bankart lesion) and/ or a capsular plication for repair of capsular redundancy.

PROCEDURE

Arthroscopic stabilization

With the examination under anesthesia completed, the arthroscope is introduced through a standard posterior arthroscopy portal. A diagnostic arthroscopy is performed and the intraarticular pathology identified and documented. Any labral detachment (i.e. Bankart lesion) is repaired using suture anchor fixation and arthroscopic tying techniques. Capsular redundancy is addressed with the use of thermal electrocapsulorrhaphy or arthroscopic suture repair of the redundant capsule. With the repair complete, 40 cc of 0.5% Bupivicaine is introduced into the joint. A sterile dressing is applied over the wounds and the operated shoulder placed in a shoulder immobilizer.

Sponsors & Collaborators

• Calgary Regional Health Authority (CRHA)

  collaborator OTHER_GOV

• Calgary Orthopaedic Research and Education Fund

  collaborator OTHER

• Canadian Orthopaedic Foundation

  collaborator OTHER

• University of Calgary

  lead OTHER

Principal Investigators

• Nicholas Mohtadi, MD, FRCSC · University of Calgary Sport Medicine Centre

• Robert Hollinshead, MD, FRCSC · University of Calgary Sport Medicine Centre

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

14 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2001-11-30

Primary Completion

2010-12-31

Completion

2013-12-31

Countries

• Canada

Study Locations