A comparative meta-analysis study of subjective and functional outcomes in operative and non-operative anterior shoulder dislocations

Anterior glenohumeral instability is a common problem in the young population. One of them is caused by anterior shoulder dislocation. The initial management of dislocation is still a matter of debate, and the prognosis shows considerable variability. This study aimed to perform a comparative analysis of the outcomes of arthroscopic intervention and conservative treatment in young, physically active individuals with traumatic anterior shoulder dislocation. Databases were searched in 2022 for comparative studies of arthroscopic and conservative management of first-time traumatic anterior shoulder dislocation. Random-effects model, heterogeneity identification using I² test, and bias analysis with the Cochrane risk of bias tool were used. Seven studies (514 subjects) were eligible. The analysis showed a significantly lower incidence of re-dislocation in the arthroscopic management group (OR 0.05[0.00, 0.11]; p<0.01; I²=70%). The findings obtained from the study on postoperative activity resumption showed that the surgical group showed a rate of 85.7% (126 out of 147), the control group showed a rate of 74 (OR 3.39, confidence interval [CI] [1.19, 9.62], p=0.02, I²=51%). Surgical or arthroscopic approaches show superiority over conservative management in terms of reducing the incidence of recurrent dislocation and return to sport after anterior shoulder dislocation. The studies in this analysis varied in post-reduction treatment approaches and lacked adequate randomization. Thus, further studies are needed to corroborate the findings of this study.