Arthroscopy: The Journal of Arthroscopic & Related Surgery
Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: Long-term evaluation
Section snippets
Methods
In 1999, Kirkley et al.14 reported the results of a randomized clinical trial in which 40 patients younger than 30 years received either immediate arthroscopic stabilization or immobilization for 3 weeks followed by identical rehabilitation.14 The study was designed as a prospective, 2-center, randomized clinical trial. It was single-blinded in that a research assistant, who was unaware of the treatment group the patient had been assigned to, performed all evaluations. To achieve this blinding,
Results
Thirty-three of the 40 original subjects were found and contacted by telephone; 31 agreed to be evaluated and returned questionnaire data, 16 from the surgical treatment group and 15 from the traditional treatment group. The average follow-up time was 79 months (range, 51 to 102 months). The groups remain similar with respect to age at first dislocation, gender mix, hand dominance, and whether or not the original dislocation occurred during sports activities (Table 1).
Since the study results
Discussion
In the knee, evidence is slowly mounting that early stabilization after a tear of the anterior cruciate ligament is in the young active patient’s best interest. It is believed that preventing the impact of loading on articular cartilage and subchondral bone that occurs during a pivoting episode and minimizing the shear loading on menisci and articular cartilage that occurs with daily activities may prevent osteoarthritis in the anterior cruciate ligament–deficient knee. Therefore, most
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Dr. Kirkley died September 8, 2002