Controversial shoulder surgery for first-time dislocation proven effective...( SAN FRANCISCO Young athletic first-...),Health

SAN FRANCISCO Young, athletic, first-time shoulder dislocation patients benefit from arthroscopic surgery long term, according to a study released today at the 2008 American Orthopaedic Society for Sports Medicine Specialty Day at The Moscone Center. The study found that for highly active patients, surgery, rather than conservative methods, yielded excellent results.

In young, active patients, there were statistics as high as 92 percent that they would dislocate their shoulder again when conservative approaches like rest and immobilization in a sling were used, says Robert A. Arciero, MD, of the Keller Army Hospital in West Point, NY. If we had an operation with a 90 percent failure rate, we would abandon the procedure. My thought was, why should we embrace a treatment with such a high failure rate"

Beginning in 1993, Dr. Arciero began performing arthroscopic surgery on young military cadets who suffered their first shoulder dislocation. The short-term results were excellent. The unknown, however, was how these patients would fare over the years.

We decided to examine these patients long-term results, says Major Brett Owens, MD, of Williams Beaumont Army Medical Center in El Paso, Texas. We found that these patients maintained their health and active lifestyle. Surgery for this group of patients was durable and provided excellent shoulder function and a high activity level even after 10 years.

Owens and his colleagues evaluated 39 patients (40 shoulder operations) whose follow-up averaged 11.7 years. Patients were evaluated with patient-derived outcomes measures and asked to compare their repaired shoulder to its function level pre-injury and whether they would be likely to have the surgery again. Additionally, they were physically assessed with a number of tests, including, how many push-ups they completed in two minutes and performance on the Army Physical Fitness Test.

Overall, the study found that the patient
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