Abstract
Introduction
The aim of the study was to compare and contrast the clinical outcome of conversion of practice of a shoulder surgeon from open to arthroscopic shoulder stabilisation for traumatic anterior shoulder instability.
Patients and Methods
Comparison of a cohort consecutive series of 24 patients treated by open stabilisation and a prospective consecutive cohort series of 30 patients treated by arthroscopic stabilisation. Clinical outcomes were assessed with Oxford Shoulder Score Instability (OSS-I) and a Patient Satisfaction Survey at a minimum of 1 year follow up. The operation time as well as cost analysis were also evaluated.
Results
The average OSS-I for open stabilisation was 39.6 (range 19-48) as compared to 39.8 (range 23-48) with the arthroscopic group and these scores did not show a statistically significant difference. Both cohorts were pleased with the clinical outcome and were happy to recommend the procedure to others. No complications in either group were seen. Operative time and costs were significantly more in the open group, even taking into account initial learning curve of the arthroscopic method. All arthroscopic procedures were performed as day-cases compared to over-night stays for the open group also providing better use of hospital resources and cost savings.
Conclusion
After appropriate surgical training, the conversion from open to arthroscopic stabilisation can be performed without affecting clinical outcome or patient satisfaction. This study provides surgeons with confidence to change methods to gain the advantages of the arthroscopic procedure, which included reduced theatre time, day case surgery and earlier return to work and sport.
