Table 1.
Author, year, country | Intervention | Control | N: recruited/FU | Follow-up time | Mean age of patients | Main outcome (primary outcome if defined) |
First-time traumatic shoulder dislocation | ||||||
Early surgery | ||||||
(I) Kirkley et al (1999)4 Canada (II) Kirkley et al (2005)15 Canada |
Arthroscopic LR | 3 weeks immobilisation | (I) 40/38 (II) 40/31 |
(I) I: 31.7 (18.1–51.1) C: 33.1 (21.8–54.2) (II) 79 (51–102) |
Intervention: 22.1* Control: 22.75* |
(I) RDR: I: 3/19 (16%)—C: 9/19 (47%) p=0.03 (II) Mean WOSI (%): I: 86%—C: 74.8%, NS |
(I) Wintzell et al (1999)7 Sweden (II) Wintzell et al (1999)16 Sweden |
Arthroscopic lavage | 1 week sling | (I) 60/57 (II) 30/30 |
(I) 1 year (II) 2 years |
(I) I: 23.5 (±3.8) C: 23.6 (±3.8) (II) Total: 24 years |
(I) RDR: I: 4/30 (13%)—C: 13/30 (43%), p=0.02 (II) RDR: I: 3/15 (20%)—C: 9/15 (60%)—p=0.03 |
Jakobsen et al (2007)3 Denmark | DA and open LR | Arthroscopic lavage | 76/75 | 2 years 10 years |
I: 23 (15–39) C: 20 (15–31) |
RDR 2 years: I: 1/37 (3%)—C: 21/39 (54%), p=0.0011 RDR 10 years I: 3/36 (9%)—C: 24/39 (62%), p not reported |
Robinson et al (2008)6 UK (Scotland) | Arthroscopic LR | Arthroscopic lavage | 88/84 | 2 years | I: 24.3 (±4.6) C: 25.3 (±4.8) |
RDR: I: 3/42 (7%)—C: 12/42 (38%), p=0.02 |
Arm position | ||||||
Itoi et al (2007)43 Japan | ERI 3 weeks | IRI 3 weeks | 198/159 | 25.6 (24–30) | I: 35 (12–90) C: 37 (12–89) |
RIR: I: 22/85 (26%)—C: 31/74 (42%), p=0.033 |
Finestone et al (2009)41 Israel | ERI 4 weeks | IRI 4 weeks | 51/51 | I: 35.8 (24–48) C: 30.8 (24–47) |
20.3 | RDR: I: 10/27 (37%)—C: 10/24 (42%), NS |
Liavaag et al (2011)44 Norway | ERI 3 weeks | IRI 3 weeks | 188/183 | 29.1 (24–54) | 26.8 (15.9– 40, ±7.1) | RDR: I: 28/91 (31%)—C: 23/93 (25%), NS RIR: I: 31/81 (38%)—C: 36/82 (42%), NS |
Heidari et al (2014)42 Iran | ERI 3 weeks | IRI 3 weeks | 102/102 | 24 | I: 36 (±7.8) C: 35.43 (±10.0) |
RIR: I: 2/51 (3.9%)—C: 17/51 (33.3%), p<0.001 |
Whelan et al (2014)45 Canada | ERI 4 weeks | IRI 4 weeks | 60/50 | 25 (12–43) | I: 23 (16–35) C: 23 (14–34) |
RDR: I: 6/27 (22%)—C: 8/25 (32%), NS |
Use of restriction band | ||||||
Itoi et al (2013)57 Japan | C+I1: MRB 3 or I2: MRB 6 weeks | ERI 3 weeks | 109/90 | I1: 26.5, I2: 26.5 C: 25.5 |
30 (15–84) | RDR: I1: 10/31 (32%)—I2: 10/30 (33%)—C: 8/29 (28%), NS |
Chronic post-traumatic shoulder instability | ||||||
Open or arthroscopic surgery | ||||||
Sperber et al (2001)46 Sweden | Arthroscopic LR | Open LR | 56/56 | 24 | I: 25 (18–51) C: 27.5 (19–45) |
RIR: I: 7/30 (23%)—Control: 3/26 (12%), NS |
Fabbriciani et al (2004)2 Italy | Arthroscopic LR | DA and open LR | 60/60 | 24 | I: 24.5 (19–33) C: 26.8 (21–30) |
CS (SD) (difference from BL (SD)): I: 89.5 (±4.25) (23 (±5.89)) points—C: 86.7 (±6.07) (20.2 (±8.22)) points, NS |
Archetti Netto et al (2012)5 Brazil | Arthroscopic LR | Open LR | 50/42 | 37.5 (20–56) | I: 27.5 (±5.4) C: 30.8 (±5.6) |
DASH (range, SD): I: 2.65 (0–24, ±7.3)—C: 4.22 (0–21, ±5.8), p=0.031 (MCID is >10)91 |
Mohtadi et al (2014)47 Canada | Open LR | Arthroscopic LR | 196/162 | 24 | I: 27.8 (16–53.7, ±7.9) C: 27.2 (16.5–59, ±9) |
WOSI (95% CI) BL →FU: I: 41.7% (37.9–45.5) → 85.2% (80.5–89.8)—C: 40.6% (36.9–44.3) → 81.9% (77.4–86.4), NS |
Absorbable or non-absorbable implant materials (anchors) | ||||||
Warme et al (1999)50 USA | Open LR, non-A SA | Open LR, bio-A SA | 38/40 | 25 (17–45) | 22 (17–46)† | Loss of ER (°): I: 3 (0–15)—C: 3 (0–10), NS |
Tan et al (2006)49 UK | Arthroscopic LR, non-A SA | Arthroscopic LR, bio-A SA | 124/124 | 2.6 (1.5–5) years | I: 27 (18–45, ±7) C: 28 (17–49, ±8) |
OSIS (SD): BL → FU: I: 36 (±8) → 18 (±6)—C: 36 (±7) → 20 (±10), p not reported |
Milano et al (2010)48 Italy | Arthroscopic LR, non-A SA | Arthroscopic LR, bio-A SA | 78/70 | 24.5 (22–29) | I: 28 (16–46) C: 28 (16–52) |
DASH (range): I: 4.5 (0–27)—C: 7 (0–25), NS |
Addition of posterior capsular plication | ||||||
Castagna et al (2009)51 Italy | Arthroscopic LR, bio-A SA | I+posterior 2-anchor capsular plication | 40/40 | 2 years | I: 29.1 C: 27.3 |
FF BL → FU: I: 169 (83–105) → 172.5 (155–180)—C: 177.8 (170–180) → 163.3 (140–175) p for change <0.001 |
Different absorbable implant materials | ||||||
(I) Magnusson et al (2006)53 Sweden (II) Elmlund et al (2009)54 Sweden |
Arthroscopic LR PLLA tacks | Arthroscopic LR PGACP tacks | 40/35 | (I) I: 25 (24–34) C: 26 (23–35) (II) I: 80 (75–95) C: 81 (64–96) |
I: 26 (16–50)‡ C: 30 (15–45)‡ |
(I) Drill hole visibility: more visible in I, p<0.004 (II) Drill hole visibility: more visible in I, p<0.0001 |
Absorbable or non-absorbable suture materials | ||||||
Monteiro et al (2008)55 Brazil | Arthroscopic LR bio-A SA+bio-A sutures | Arthroscopic LR bio-A SA+non-A sutures | 50/45 | I: 31.5 (24–45) C: 30.9 (24–45) |
23.5 (16–37) | Rowe (range): I: 83.81 (35–100)—C: 79.58 (35–100), NS |
Rehabilitation | ||||||
Kim et al (2003)56 Korea | Accelerated | Traditional | 62/62 | 31 (27–45, ±9) | I: 29 (15–38, ±5.8)‡ C: 28 (18–39, ±5.6)‡ |
RDR: 0/62 (0%), subluxation rate: 0/62 (0%), NS |
Anatomic versus non-anatomic surgical techniques | ||||||
Salomonsson et al
(2009)52 Sweden |
Open LR and capsular imbrication | Modified Putti-Platt procedure | 66/62 | 143 (121–162, ±12.2) | I: 29 (17–52)‡ C: 26 (16–63)‡ |
Rowe: I: 90, C: 90, NS |
Follow-up times are tabulated as presented in the original publication as mean (range) in months unless noted otherwise. Mean age is presented as mean (range) or mean (±SD) or mean (range ±SD) in years unless noted otherwise. The point of recording participant age was not specified in the publication, unless marked otherwise (*at first dislocation, †at surgery, ‡preoperatively).
Bio-A, bio-absorbable; BL, base level; C, control; CS, constant score; DA, diagnostic arthroscopy; DASH, disabilities of the arm, shoulder and hand; ER, external rotation; ERI, external rotation immobilisation; FF, forward flexion (in degrees); FU, follow-up; I, intervention; IRI, internal rotation immobilisation; LR, labrum repair; MCID, minimal clinically important difference; MRB, motion restriction band; non-A, non-absorbable; NS, no statistically significant difference; OISS, Oxford Instability Shoulder Score; PGACP, polygluconate co-polymer; PLLA, polylactic acid; RDR, redislocation rate; RIR, recurrent instability rate; SA, suture anchor; WOSI, Western Ontario Shoulder Instability Index Score.