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I have been to two different orthopedic surgeons about my shoulder. They both recommended doing a Bankart repair. The first surgeon described the surgery as being an open procedure. The second surgeon said, "No, an arthroscopic approach is better." How do I decide between the two?

When faced with two opposing opinions about surgery, it may be a good idea to seek a third opinion. And there is nothing wrong with going back to the first two surgeons and asking for a review of their thinking on this decision. This repeat discussion may help clear some things up in your mind. We can offer some information on this very topic from a recent study performed by the American Board of Orthopaedic Surgery (ABOS). They were looking for trends in surgeon practice. Starting in 2003 and going through 2008, data was analyzed to compare these two approaches when doing the Bankart Repair for shoulder instability. They saw that the majority of surgeons are using an arthroscopic approach to the Bankart repair. In 2003, 71 per cent of the orthopedic surgeons did it this way. By 2008, that figure was up to 90 per cent. The reason for this trend shifting from open to arthroscopic Bankart repairs? Well, there may be several. First, any arthroscopic surgery has the potential to be less invasive compared to an open incision approach. Second, improved surgical technique with arthroscopy has led to a lower rate of complications. And third, studies over time are showing improved final outcomes when this surgery is done arthroscopically. The results of long-term studies (10 to 20 years later) are still lacking when it comes to looking at final outcomes for arthroscopic versus open Bankart procedures. But so far the short-term results reported have been very favorable.

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