Editorial Commentary: Conversion to Arthroscopy Is Twice the Cost of Rehabilitation and More Costly Than Early Arthroscopy.

Abstract

First-time anterior shoulder dislocations pose a surgical indication challenge for orthopaedic surgeons. Despite ample evidence suggesting a reduction in secondary instability, improved patient-reported and quality-of-life outcomes, and improved satisfaction for patients undergoing early arthroscopic management, conservative management is a common choice for these patients. Recent literature has identified that conversion to arthroscopic management for patients with first-time anterior shoulder instability was twice the out-of-pocket expense of conservative management and more expensive, on average, than primary management with arthroscopy. Although insignificant, the increased cost of arthroscopic conversion for these patients likely reflects global costs to both patients and the health care system. As such, in the context of time spent away from sport or work, redislocation rate, patient-reported outcomes, and future surgery, aggressive, early surgical management of high-risk patients is imperative.