Surgical versus non-surgical treatment for first-time traumatic anterior shoulder dislocation with a bankart lesion: 10-years randomised controlled clinical trial

Boadas Gironès, Laia
Background: Anterior traumatic dislocation is a common problem faced by orthopaedic surgeons. After a first episode of shoulder dislocation, a combination of lesions can lead to chronic instability or re-dislocations episodes. The management after the first acute anterior shoulder dislocation is controversial. Nowadays, the treatment choose is a conservative management by immobilization, although the available literature supports the early surgical treatment, especially in a close-defined population with a high risk of recurrences (young, male, athletes and/or with a high demanded physical activities). However, further clinical trials of good quality comparing surgical versus non-surgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence. Our aim is to try to solve this weak point. Objective: The aim of this protocol is to compare the effectiveness between the surgical versus nonsurgical treatment for the first-time traumatic anterior dislocation of the shoulder with Bankart lesion. The surgery used, will be the arthroscopic Bankart repair. Design: Our design will be a randomized, controlled, single-blind and unicentric clinical trial. It will be done in Hospital Universitari Dr. Josep Trueta in Girona with the Orthopaedics and Trauma Surgery (OTS) Department. Patient could be derived from all Girona’s province. Participants: We include physically active individuals (score of 40-80 in the Physical Activity Index of American Academy of Health and Fitness (AAHF)) with ages between 18 and 30 years old, and with a gender rate of 9 Males : 1 Female. (9M:1F) The lesion should be a first-time episode traumatic anterior dislocation with a Bankart lesion diagnosed by Magnetic Ressonance Imaging arthrography (arto-MRI) ​
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