Studies that compared surgical treatment to non-operative treatment for first-time traumatic anterior shoulder dislocation were eligible for inclusion, as were studies that compared open surgical treatment to arthroscopic surgical treatment using suture anchors for anterior shoulder instability. Studies that did not use suture anchors were excluded, as were those where a bone block procedure was used or components of instability other than anterior were present. The main outcome was the rate of recurrent instability, plus outcome scores for instability based on a number of scales, or the Rowe score.
Included studies comprised randomised controlled trials (RCTs), cohorts and case-control studies. The mean age of participants in studies comparing surgical treatment to non-operative treatment was less than 23.3 years; for studies comparing open surgical treatment to arthroscopic surgical treatment the mean age ranged between 20 to 35 years. The majority of patients were males.
The authors did not state how the papers were selected for review, or how many reviewers performed the selection.