What is the best surgical repair for a recurrent shoulder dislocation in an athlete?
The best operative repair for recurrent shoulder instability in an athlete is the one that can address the pathology, not lose motion as a goal of the surgery, and have low complication and recurrence rates. Both open instability repairs and, more recently, arthroscopic repairs have satisfied these criteria. Data exists to suggest that in collision athletes open repair may have a lower recurrence rate, but other studies show that arthroscopic repair is equal. The subscapularis tendon is not taken down in arthroscopic repairs. The ability to assess and address concomitant pathology such as SLAP lesions, partial cuff tears, and articular cartilage injury is superior with arthroscopy in the athletic population. That being said, the surgeon should perform the operation that he or she feels most comfortable with and is best at, and that addresses the pathology of recurrent shoulder instability.
