Arthroscopic Stabilization of the Acute, First-Time Shoulder Dislocation

Arthroscopic management for shoulder instability has gained wider acceptance among both patients and orthopedic surgeons during the past 15 years. Advances in surgical instrumentation allow the surgeon to perform essentially the same repair, whether accomplished through the arthroscope or via a deltopectoral incision. An acute, initial traumatic anterior shoulder dislocation sustained by a young adult provides the optimal situation to repair both the pathologic Bankart lesion and minimize the development of secondary joint pathology that comes with recurrent instability. The author's preferred arthroscopic technique using nonmetallic anchors and permanent sutures is described. This technique stresses the low morbidity of the approach and the reestablishment of the anatomic repair of the Bankart lesion and any concomitant pathology noted at arthroscopy.