Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation: expected-value decision analysis

Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

“…Our search and calculations clearly demonstrated that reduction of recurrence rates in all studies was much higher in the arthroscopic surgical treatment than the non-operative treatment. The results of this systematic review reinforce the previous studies reporting [2][3][4]27) that arthroscopic Ban- kart repair is a more effective treatment for reducing the number of recurrent dislocations in patients with first-time traumatic anterior shoulder dislocations, when compared to non-operative treatment. One 16) of the studies in this systematic review had…”

“…1) Treatment options include primary arthroscopic surgical capsulolabral repair or non-operative (conservative) treatment. Many systematic reviews [2][3][4] reported that arthroscopic surgical repair is superior to non-operative treatment in terms of recurrent episodes of shoulder dislocations, especially in young patients participating in intense physical activity (e.g., contact sports). 3) Since the effectiveness of arthroscopic repair has been well documented, the next logical step would be to determine the degrees of effectiveness when compared with non-operative treatment.…”

“…Many systematic reviews [2][3][4] reported that arthroscopic surgical repair is superior to non-operative treatment in terms of recurrent episodes of shoulder dislocations, especially in young patients participating in intense physical activity (e.g., contact sports). 3) Since the effectiveness of arthroscopic repair has been well documented, the next logical step would be to determine the degrees of effectiveness when compared with non-operative treatment. Summarizing treatment effects from randomized clinical trials (RCTs), in terms of the numbers-needed-to-treat (NNT) and relative risk reduction (RRR), is helpful to physicians and clinicians in making a decision.…”

Outcomes of Arthroscopic Anterior Shoulder Instability in the Beach Chair Versus Lateral Decubitus Position: A Systematic Review and Meta-Regression Analysis

“…The ability to place enough anchors and to achieve adequate capsular tension is predicated on the ability to place the first anchor low on the anterior inferior glenoid rim. 28 Often, the anchor's trajectory makes it difficult to achieve this inferior position without damaging the articular surface, and ultimately the integrity of the repair may be compromised. The difference between a stable repair with adequate soft tissue tensioning and an unstable repair with residual capsulolabral laxity may be subtle and potentially may go unnoticed intraoperatively.…”

BESS/BOA Patient Care Pathways

“…Primary surgery was not only more effective, but also more costly for 25-year-old females and 35-year-old males and females Expected-value decision analysis 70 , a tool evaluating patients' expectations for different disease states, was performed on arthroscopic repair versus non-operative management. Using utility values (where 0 represents the worst possible outcome and 10 is the best), non-operative treatment was associated with a utility value of 5.9 versus 7.6 for arthroscopic treatment.…”