ANALYSIS OF OUTCOME OF ARTHROSCOPIC VERSUS OPEN ANTERIOR STABILISATION OF THE SHOULDER.

Abstract

To compare the effectivity of arthroscopic and open stabilisation of the shoulder. Between 2003 and 2006, 100 patients (20 female, 80 male; mean age 32 years) undergoing glenohumeral stabilisation were followed prospectively. 28 were open (3 female, 25 male; mean age 30.7 years), 72 arthroscopic (17 female, 55 male; mean age 32.0 years). Assessments were made using the Constant, DASH, and Carter-Rowe (CR) scores, as well as the Oxford Shoulder Instability Questionnaire (OSIQ) pre-operatively, at three and six post-operative months, and six-monthly thereafter. The student’s t test was used to compare the mean scores at each time point. Correlation coefficients (Pearson’s) were used to compare the postoperative course with either intervention. In general the open group performed marginally less well than did the arthroscopic. However, the DASH score demonstrated less consistency both in this relationship, and the rate of post-operative recovery when compared with the other scoring systems. In the open surgery group the DASH revealed a deterioration from the pre-operative score at six months before subsequent improvement; in the arthroscopic group, this deterioration occurred at three months. However, these differences were not statistically significant regardless of the assessment tool employed. Strong correlation was demonstrated between the rates of recovery following either surgery (Constant r=0.99; OSIQ r=1.00; CR r=0.94). Again, this was not supported by the DASH (r= −0.868). The rates of improvement were identical with either treatment when measured with the Constant, OSIQ, and CR, whilst the DASH score yielded inconsistent results. No significant difference could be shown between open and arthroscopic surgery at any individual time point regardless of the assessment tool employed. We suggest that open and arthroscopic surgeries yield very similar outcomes.