Two-Year Follow-Up of Randomized Controlled Trial of Arthroscopic Bankart Repair with and Without Arthroscopic Infraspinatus Remplissage in Anterior Shoulder Instability with Hill-Sachs Defect

Background: The objective of the study was to evaluate the functional outcome of arthroscopic Bankart repair for anterior shoulder instability to assess whether the number and position of suture anchors plays a role in determining the functional outcome.Methods: This was a prospective study on 32 patients operated with arthroscopic Bankart repair between December 2017 to April 2019. Pre-op and regular follow-up scores were measured at 1 month, 3 months and 6 months post-op using Rowe score and American Shoulder and Elbow Surgeons score to assess functional outcome.Results: Mean age of the study group was 24.5±6.9 years. Functional outcome as determined by Rowe score and ASES score at 6 months follow-up were found to be 90.5±7.2 and 85.9±14.1 respectively when compared to the pre-op scores of 23.2±8.2 and 47.9±5.7 respectively; all of which showed highly significant functional improvement with highly significant reduction in visual analog scale (VAS) pain score. Patients had no recurrent dislocations with mean external rotation limitation of 5o. 25 (78.1%) patients had two suture anchors inserted and 7 (21.9%) patients had multiple (>2) anchors; and when analysis was done, there was no statistically significant difference between number of suture anchors used with respect to the functional scores.Conclusions: We conclude that arthroscopic Bankart repair is a useful and successful procedure. Patient identification and selection remains the key in determining the success of repair. Meticulous surgical technique and correct positioning of suture anchors may help in reducing the number of anchors without compromising on the final functional outcome, thereby reducing the economic burden on patients.

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A Multicenter Retrospective Study With a Minimum 5-Year Follow-up Comparing Arthroscopic Bankart Repair and the Latarjet Procedure

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120941366 ◽

2020 ◽

Vol 8 (8) ◽

pp. 232596712094136

Author(s):

Eran Maman ◽

Oleg Dolkart ◽

Rafael Krespi ◽

Assaf Kadar ◽

Gabriel Mozes ◽

...

Keyword(s):

Shoulder Instability ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Published Data ◽

Return To Sports ◽

Latarjet Procedure ◽

Recurrent Instability ◽

Arthroscopic Bankart Repair ◽

Functional Scores

Background: Arthroscopic Bankart repair (ABR) and the Latarjet procedure are surgical techniques commonly used to treat anterior shoulder instability. There is no consensus among shoulder surgeons regarding the indications for choosing one over the other. Purpose: To compare the results of the Latarjet procedure with those of ABR for the treatment of anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Data on all patients who were treated surgically for recurrent anterior shoulder instability between 2006 and 2011 were retrospectively collected at 4 medical centers. The minimum follow-up was 5 years. Data were retrieved from medical charts, and patients were interviewed to assess their level of satisfaction (range, 0-100), functional outcomes (using the American Shoulder and Elbow Surgeons shoulder score; the Subjective Shoulder Value; and the Disabilities of the Arm, Shoulder and Hand score), and quality of life (using the 12-Item Short Form Health Survey [SF-12]). Information on return to sports activities and postoperative level of activity compared with that of the preinjury state, complications, reoperations, and recurrent instability were recorded and evaluated. Results: A total of 242 patients were included. The Latarjet procedure was performed in 27 shoulders, and ABR was performed in 215 shoulders. Patients in the ABR group had significantly higher rates of redislocation (18.5%; P = .05) and subluxation (21.4%; P = .43) but a lower rate of self-reported apprehension (43.0%; P = .05) compared with patients in the Latarjet group (3.7%, 14.8%, and 63.0%, respectively). There were 5 patients in the ABR group who underwent reoperation with the Latarjet procedure because of recurrent instability. The functional scores in the Latarjet group were better than those in the ABR group. The SF-12 physical score was significantly better in the Latarjet group than in the ABR group (98.1 vs 93.9, respectively; P = .01). Patient satisfaction and subjective scores were similar in both groups. Conclusion: These results support recently published data on the Latarjet procedure that showed its superiority over ABR in midterm stability (dislocations or subluxations). The contribution of self-reported apprehension to the broad definition of stability is not clear, and apprehension rates were not correlated with satisfaction scores or the recurrence of dislocation or subluxation.

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Outcomes of the Latarjet procedure for the treatment of chronic anterior shoulder instability: patients with prior arthroscopic Bankart repair versus primary cases

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00204 ◽

2019 ◽

Vol 7 (5_suppl3) ◽

pp. 2325967119S0020

Author(s):

Jean-David Werthel ◽

Vincent Sabatier ◽

Lior Amsallem ◽

Marie Vigan ◽

Alexandre Hardy

Keyword(s):

Shoulder Instability ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Latarjet Procedure ◽

Sports Activity ◽

Simple Shoulder Test ◽

Arthroscopic Bankart Repair ◽

Functional Scores ◽

The Mean

Objectives The two most common surgical interventions for recurrent anterior shoulder instability include arthroscopic Bankart repair and the Latarjet procedure. However, indications for each procedure remain debated between surgeons with 90% of surgeons (except French surgeons) preferring soft tissue Bankart repair initially. It remains unclear whether the results of a Latarjet procedure performed after a failed arthroscopic Bankart repair differ from those performed for primary cases. The purpose of our study was to compare the postoperative outcomes of patients who had undergone a Latarjet as a primary surgery versus those who had had a Latarjet as revision surgery for a failed arthroscopic Bankart repair Methods Patients who had undergone open or arthroscopic Latarjet procedure between 2003 and 2015 in 5 fellowship-trained surgical practices were included. Charts were retrospectively reviewed to identify patients who had undergone a primary Latarjet or those who had had a Bankart repair prior to the Latarjet. Age, ISIS score, BMI, sports activity, hyperlaxity and delay before surgery were retrospectively collected. Outcome measures were prospectively collected, including range of motion, SSV, Walch-Duplay, scores, recurrence of instability, apprehension or new surgery. Results A total of 311 patients were included. 28% of the patients were lost to follow-up and the mean follow-up was 3.4 years +/-0.8. There were 21 patients who had had a Bankart repair prior to the Latarjet procedure. Both populations were comparable regarding preoperative data. The postoperative instability rate was 3% in the overall population; 4.8% in the “primary Latarjet” group and 2.3% in the ”Latarjet for failed Bankart” group. This difference was not significant (p=0.50). However, the mean Walch-Duplay score was significantly lower and the pain scores significantly higher in patients who had had a prior Bankart repair: 51.9 +/- 25 versus 72.1 +/- 25.2 and 2.5/10 versus 1.2/10 respectively. The Simple Shoulder Test was comparable in both groups. Conclusion The study confirms that the Latarjet is an effective procedure to treat primary chronic anterior instability and also to stabilize a shoulder after a failed Bankart repair. However, the thought that a Bankart repair does not “burn any bridges” appears to be incorrect relative to postoperative pain and functional scores in the setting of future Latarjet procedure.

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Functional Rehabilitation and Return to Play After Arthroscopic Surgical Stabilization for Anterior Shoulder Instability

Sports Health A Multidisciplinary Approach ◽

10.1177/19417381211062852 ◽

2021 ◽

pp. 194173812110628

Author(s):

Timothy D. Kelley ◽

Stephanie Clegg ◽

Paul Rodenhouse ◽

Jon Hinz ◽

Brian D. Busconi

Keyword(s):

Shoulder Instability ◽

Return To Sport ◽

Rehabilitation Program ◽

Return To Play ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Functional Rehabilitation ◽

Arthroscopic Bankart Repair ◽

Redislocation Rate

Background: There exists limited objective functional return-to-play criteria after surgical stabilization for anterior shoulder instability in the competitive athlete. Hypothesis: The proposed functional rehabilitation program and psychological evaluation after arthroscopic Bankart repair will help athletes return to sport with a decreased redislocation rate on return. Study Design: Case series. Level of Evidence: Level 4. Methods: Participants were contact or overhead athletes at the high school or collegiate level. Each underwent arthroscopic Bankart repair after a single dislocation event, with less than 10% glenoid bone loss. Western Ontario Shoulder Instability Index (WOSI) scores, Single Assessment Numeric Evaluation (SANE) scores, and American Shoulder and Elbow Surgeons (ASES) scores were evaluated pre- and postoperatively. Athletes were only allowed to return to competition after completing the proposed functional and psychological rehabilitation protocol. Results: A total of 62 participants were enrolled (52 male, 10 female; average age, 18.7 years (range 16-24 years); mean Instability Severity Index Score, 5.63 ± 0.55). All returned to sport for 1 full season and completed a minimum of 2 years of follow-up. The average time to pass functional testing was 6.2 ± 0.7 months, psychological testing was 5.2 ± 0.5 months, and return to sport was 6.5 ± 0.7 months. SANE scores improved from 44.3 to 90.0, ASES from 45.5 to 89.3, and WOSI from 1578.0 to 178.9 (all P < 0.001). Redislocation rate was 6.5% (4 of 62). Conclusion: The proposed functional rehabilitation and psychological assessment protocol is safe and effective in returning athletes to sport after arthroscopic surgical intervention for anterior shoulder instability. This demonstrated a low redislocation rate after 2-year follow-up. Clinical Relevance: Most return-to-play protocols after arthroscopic Bankart repair are centered on recovery time alone, with limited focus on functional rehabilitation, psychological assessment, and return-to-play testing parameters. To our knowledge, this is the first study to propose a dedicated rehabilitation program incorporating functional testing, psychological readiness, and return-to-play criteria for competitive athletes recovering from arthroscopic shoulder stabilization.

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Arthroscopic Bankart Repair With Knotless Suture Anchor for Traumatic Anterior Shoulder Instability: Results of Short-Term Follow-Up

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(08)70215-2 ◽

2007 ◽

Vol 2007 ◽

pp. 16-17

Author(s):

R.J. Goitz

Keyword(s):

Shoulder Instability ◽

Suture Anchor ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Short Term ◽

Arthroscopic Bankart Repair ◽

Knotless Suture Anchor

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Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability After a Failed Arthroscopic Soft-Tissue Repair Yields Comparable Failure Rates to Primary Bankart Repair: A Systematic Review

HSS Journal ® ◽

10.1177/15563316211030606 ◽

2021 ◽

pp. 155633162110306

Author(s):

Ajaykumar Shanmugaraj ◽

Seaher Sakha ◽

Tushar Tejpal ◽

Timothy Leroux ◽

Jacob M Kirsch ◽

...

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Shoulder Instability ◽

Bankart Repair ◽

Quality Data ◽

Anterior Shoulder Instability ◽

Failure Rates ◽

Recurrent Instability ◽

Arthroscopic Bankart Repair

Background: The management of recurrent instability after arthroscopic Bankart repair remains challenging. Of the various treatment options, arthroscopic revision repairs are of increasing interest due to improved visualization of pathology and advancements in arthroscopic techniques and instrumentation. Purpose: We sought to assess the indications, techniques, outcomes, and complications for patients undergoing revision arthroscopic Bankart repair after a failed index arthroscopic soft-tissue stabilization for anterior shoulder instability. Methods: We performed a systematic review of studies identified by a search of Medline, Embase, and PubMed. Our search range was from data inception to April 29, 2020. Outcomes include clinical outcomes and rates of complication and revision. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. Results: Twelve studies were identified, comprising 279 patients (281 shoulders) with a mean age of 26.1 ± 3.8 years and a mean follow-up of 55.7 ± 24.3 months. Patients had improvements in postoperative outcomes (eg, pain and function). The overall complication rate was 29.5%, the most common being recurrent instability (19.9%). Conclusion: With significant improvements postoperatively and comparable recurrent instability rates, there exists a potential role in the use of revision arthroscopic Bankart repair where the glenoid bone loss is less than 20%. Clinicians should consider patient history and imaging findings to determine whether a more rigorous stabilization procedure is warranted. Large prospective cohorts with long-term follow-up and improved documentation are required to determine more accurate failure rates.

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