In this study, the results of open versus arthroscopic repair of anterior shoulder instability is compared. The main measure used was muscle strength.
Patients with anterior shoulder instability were divided into two groups. Anterior shoulder instability means there is chronic shoulder dislocation in a forward direction. Both groups had surgery to repair the damage. The name of the operation is a Bankart repair.
The first group had an arthroscopic Bankart repair. A thin needle is inserted into the joint. A tiny TV camera on the end gives the surgeon a clear view of the structures. The second group had an open repair. An incision is made to cut open the skin and soft tissues underneath.
Some studies have compared the results from these two methods. This is the first to look at muscle strength. Patients were followed up to 12 months after the operation.
The results showed that muscle strength recovers faster after an arthroscopic Bankart repair. Strength was back to normal at six months for the arthroscopic group. Muscle strength was slower to recover in the patients who had an open Bankart repair. But by the end of 12 months, there was no difference between the two groups.
The authors suggest that recovery after an open repair takes longer because damage to the soft tissues is greater. The subscapularis muscle responsible for internal rotation is especially affected.
But once the subscapularis tendon and muscle heal, then strength recovers fully. Weakness of the internal rotator muscle may be prolonged if there is scarring or shortening of the subscapularis tendon after the operation.
Shoulder rehab can start sooner and progress faster after an arthroscopic Bankart repair. Contact sport activities can begin as early as three to four months after this method of repair. Close supervision during rehab is advised to promote faster functional return without complications.