Implications for health care
The ARTISAN trial found no evidence of a difference between referring patients to a programme of physiotherapy and referring patients for a single session of advice with a physiotherapist. However, a programme of physiotherapy is cost-effective and could be considered for patients who are not experiencing recovery as expected or who express a strong preference for supervised physiotherapy, who could self-refer for a supervised programme of physiotherapy. This will provide a balance between best use of NHS resources, empowering patients and reducing unnecessary appointments for those who can self-manage.
Implications for research
Further research should be directed towards optimising self-management strategies in this population. The ARTISAN trial was designed to address all patients who sustain a first-time shoulder dislocation; further research may also be directed towards populations who sustain recurrent shoulder dislocations.