Arthroscopic Versus Open Repair for Traumatic Anterior Shoulder Instability: A Meta‐analysis
Bibliographic record
Abstract
PURPOSE: The purpose of this study was to critically evaluate the literature to determine whether open or arthroscopic surgical repair for traumatic recurrent anterior shoulder instability results in a better outcome. TYPE OF STUDY: Meta-analysis. METHODS: The search involved clinical studies in all languages in the MEDLINE database from 1966 to October 31, 2003. The following key words were used: (1) anterior shoulder instability, (2) Bankart lesion, (3) traumatic recurrent anterior shoulder instability, and (4) arthroscopic and open Bankart repair. All abstracts were reviewed and articles were included if there was a direct clinical comparison between arthroscopic and open repair for traumatic recurrent anterior shoulder instability. These articles were manually cross-referenced for additional abstracts. The final group of articles was independently critically appraised and the following outcomes were extracted: recurrent instability, return to activity, reoperation rate, and cause of recurrence. RESULTS: The search terms resulted in 677, 183, 68, and 51 hits respectively. From these, 18 articles were determined to be eligible for full review including 2 foreign-language articles. Cross-referencing identified 2 unpublished studies. Eleven studies were included in the final analysis: 1 randomized trial, 2 pseudo-experimental designs, 4 prospective cohorts, 3 retrospective studies, and 1 case control study. Pooled Mantel-Haenszel odds ratio for recurrent instability and return to activity were 2.04 ( P = .003; 95% confidence interval, 1.27, 3.29) and 2.85 ( P = .004; 95% confidence interval, 1.40, 5.78), respectively, in favor of the open repair. CONCLUSIONS: Based on this meta-analysis, open repair has a more favorable outcome with respect to recurrence and return to activity. LEVEL OF EVIDENCE: Level III, Systematic Review of Level III (and II/I) Studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.039 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.035 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".