Coracoid bone block versus arthroscopic Bankart repair: A comparative paired study with 5-year follow-up

ObjectivesRisk factors for anterior shoulder dislocation include young age, contact activities and male sex. The influence of sex on patient-reported outcomes of arthroscopic Bankart repair (ABR) is unclear, with few studies reporting potential differences. This study’s purpose was to compare patient-reported outcomes of males and females following ABR.MethodsProspectively collected data was analysed for 281 patients (males: 206, females: 75) after ABR with preoperative, 1-year and 2-year follow-up responses. The Wilcoxon signed-rank and χ2 tests, preoperative, 1 year and 2 year follow-up results were examined to determine differences of scores in males versus females.ResultsNo statistically significant sex differences were observed in Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Visual Analogue Scale (VAS) or Single Assessment Numerical Evaluation (SANE) Scores at 1-year or 2-year follow-up. Females had lower Veterans RAND 12-item health survey (VR-12) mental health subscores at 2-year follow-up (females: 52.3±9.0, males: 55.8±7.6, p=0.0016). Females were more likely to report that treatment had ‘exceeded expectations’ at 2-year follow-up regarding motion, strength, function and normal sports activities.ConclusionResults of study demonstrate that ABR has similar outcomes for both males and females. There were no statistically significant sex-related differences in SST, ASES, VAS or SANE scores following ABR. VR-12 mental health subscores showed a minimal difference at 2-year follow-up, with lower scores in females.Level of evidenceRetrospective cohort study; level II.

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Long-term Follow-up of Acute Arthroscopic Bankart Repair for Initial Anterior Shoulder Dislocations in Young Athletes

The American Journal of Sports Medicine ◽

10.1177/0363546508328416 ◽

2009 ◽

Vol 37 (4) ◽

pp. 669-673 ◽

Cited By ~ 117

Author(s):

Brett D. Owens ◽

Thomas M. DeBerardino ◽

Bradley J. Nelson ◽

John Thurman ◽

Kenneth L. Cameron ◽

...

Keyword(s):

Bankart Repair ◽

Young Athletes ◽

Arthroscopic Bankart Repair ◽

Long Term Follow Up

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Latarjet procedure for failed arthroscopic Bankart repair: a case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20201952 ◽

2020 ◽

Vol 8 (5) ◽

pp. 1921

Author(s):

I. G. N. Wien Aryana ◽

Rizki Zainuraditya

Keyword(s):

Shoulder Dislocation ◽

Coracoid Process ◽

Bankart Repair ◽

Anterior Shoulder Dislocation ◽

Latarjet Procedure ◽

Recurrence Rates ◽

Arthroscopic Bankart Repair ◽

Long Term Follow Up

Arthroscopic Bankart Repair (ABR) provides acceptable results for recurrent anterior shoulder dislocation. However, recent studies have shown recurrent rates of 4-19% or even up to 35-40% in patients aged <25 years, and the results tend to get worse after long-term follow-up. The Latarjet procedure can improve anterior stability by multiple mechanisms, not only can the Bankart lesion be repaired and provide stability, but the transfer of the coracoid process extends the bony articular arc of the glenoid, and the addition of the conjoint tendon may provide dynamic stability as well. The Latarjet procedure for correcting recurrent anterior shoulder dislocation led to good and excellent results in 82.7% of the cases. The Latarjet procedure had the lowest re-dislocation rate, which was significantly lower than the arthroscopic Bankart repair. Latarjet procedure is effective in terms of restoring anteroinferior glenohumeral stability and good option for failed arthroscopic Bankart repair. Recurrence rates of instability are acceptable and re-operation rates were low.

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Return to sport and patient satisfaction after arthroscopic Bankart repair: a single-institution experience

Singapore Medical Journal ◽

10.11622/smedj.2021030 ◽

2021 ◽

Author(s):

YB Tan ◽

KL Puah ◽

RWW Chong ◽

KL Ong ◽

YJ Lim ◽

...

Keyword(s):

Patient Satisfaction ◽

Return To Sport ◽

Bankart Repair ◽

Return To Sports ◽

Competitive Sports ◽

Simple Shoulder Test ◽

Independent Observer ◽

Arthroscopic Bankart Repair ◽

Recurrent Shoulder Dislocation

Introduction: Arthroscopic Bankart repair is a widely accepted procedure to treat recurrent shoulder dislocation. This study aims to describe our experience with arthroscopic Bankart repair and its functional outcome. Methods: 107 patients who underwent arthroscopic Bankart repair from 2008 to 2013 were followed up for a minimum of three years and reviewed by an independent observer. 80 consented to being interviewed using the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test. Results: 82 shoulders (two bilateral) were studied. Mean age at first dislocation was 19.4 ± 3.4 (12.0–31.0) years. Mean follow-up was 4.4 ± 1.3 (3.0–9.0) years and 2.5 ± 3.0 (0.1–15.4) years elapsed from first dislocation to surgery. 41 (50.0%) patients played overhead or contact sports and 44 (53.7%) played competitive sports before injury; 8 (9.8%) patients reported recurrence of dislocation, which was significantly associated with playing competitive sports before injury (p < 0.039), 5 (6.1%) underwent revision surgery and 22 (26.8%) reported residual instability after surgery. 49 (59.8%) patients returned to playing sports, 75 (91.5%) were satisfied with their surgery and 79 (96.3%) were willing to undergo the surgery again. 74 (90.2%) patients had two-year good/excellent OSIS, which was significantly associated with playing competitive sports before injury (p = 0.039), self-reported stability after surgery (p = 0.017), satisfaction with surgery (p = 0.018) and willingness to undergo surgery again (p = 0.024). Conclusion: Arthroscopic Bankart repair yields good functional outcomes and is associated with high patient satisfaction, although not all patients return to sports.

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Large Drill Holes Are Still Present in the Long Term After Arthroscopic Bankart Repair With Absorbable Tacks: An 18-Year Randomized Prospective Study

The American Journal of Sports Medicine ◽

10.1177/0363546520922191 ◽

2020 ◽

Vol 48 (8) ◽

pp. 1865-1872

Author(s):

Christina Chrysanthou Constantinou ◽

Ninni Sernert ◽

Lars Rostgård-Christensen ◽

Jüri Kartus

Keyword(s):

Study Groups ◽

Drill Hole ◽

Ct Images ◽

Bankart Repair ◽

Plain Radiographs ◽

Arthroscopic Bankart Repair ◽

Absorbable Tacks ◽

Drill Holes

Background: Studies have demonstrated the development of an osseous reaction at the drill sites of anchors after arthroscopic shoulder surgery. Purpose: To investigate the drill-hole size at 18 years after arthroscopic Bankart repair using either fast polygluconate acid (PGA) or slow polylevolactic acid (PLLA) absorbable tacks and to compare the functional outcomes and development of osteoarthritis. Study design: Randomized controlled trial; Level of evidence, 2. Methods: 40 patients with unidirectional anterior shoulder instability, treated with arthroscopic Bankart repair, were randomized into the PGA group (n = 20) or the PLLA group (n = 20). Plain radiographs of both shoulders, as well as computed tomography (CT) images of the operated shoulder, were used to evaluate the drill-hole size, volume, and degenerative changes. Functional outcomes were assessed by use of the Rowe score, Constant score, and Western Ontario Shoulder Instability (WOSI) index. Results: Of the 40 patients, 32 patients returned for the follow-up (15 PGA and 17 PLLA). No significant differences were found in the population characteristics between the study groups. The mean follow-up time was 18 years for both groups. No significant differences were seen in range of motion, strength in abduction, or Constant, Rowe, and WOSI scores between the groups. Recurrence rate was 33% in the PGA group and 6% in the PLLA group during the follow-up period ( P = .07). The drill-hole appearance on plain radiographs (invisible/hardly visible/visible/cystic) was 11/2/2/0 and 6/5/5/1 for the PGA and PLLA groups, respectively ( P = .036). The mean ± SD drill-hole volume as estimated on CT images was 89 ± 94 and 184 ± 158 mm3 in the PGA and PLLA groups, respectively ( P = .051). Degenerative changes (normal/minor/moderate/severe) on plain radiographs were 7/4/4/0 and 3/8/5/1 for the PGA and PLLA groups, respectively ( P = .21), and on CT images were 5/7/3/0 and 2/6/6/3 for the PGA and PLLA groups, respectively ( P = .030). Conclusion: This long-term follow-up study demonstrated that the PLLA group had significantly more visible drill holes than the PGA group on plain radiographs. However, this difference was not evident on CT imaging, with both groups having several visible cystic drill holes and a substantial drill-hole volume defect. No significant differences were found between the study groups in terms of clinical outcomes.

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Recurrent Anterior Glenohumeral Instability-Arthroscopic Results of Bankart Repair

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00268 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0026

Author(s):

Ahmet Guney ◽

İbrahim Karaman ◽

Murat Kahraman ◽

Mithat Öner ◽

Erdal Uzun ◽

...

Keyword(s):

Open Surgery ◽

External Rotation ◽

Arthroscopic Repair ◽

Daily Activities ◽

Bankart Repair ◽

Shoulder Abduction ◽

Arthroscopic Bankart Repair ◽

The Mean ◽

The Difference

Objectives: In the treatment of traumatic anterior shoulder instability there is still not formed a ideal consensus. Although the results of the open technique for repairing Bankart lesions detected in these patients, in recent years with the development of arthroscopic methods, arthroscopic Bankart repair with the successful results are obtained. We aimed to present our results of Bankart repair with the arthroscopic method. Methods: The study included 42 patients who underwent arthroscopic Bankart repair in our clinic between the years 2011-2014. Mean age was 26.3 (18-37). Preoperative and postoperative pain and functions of the patients were assessed using the Constant and Rowe scores. The mean follow-up period was 19 months (range 6 to 30 months). Patients with at least two dislocations were included in the study. The mean number of dislocations was 4.8 (2-10). The mean time from the first trauma to surgical intervention was 2.5 years (range 0.5 to 10 years). Patients with multidirectional instability were excluded. Repair was performed using double-stranded double with the standard anterior portal. Decision for surgical treatment was made based on limitation of activities because of fear of having a dislocation and on positive results of instability tests. Before surgery for all patients, a detailed clinical examination, conventional radiography and conventional MRI were evaluated. All the patients had labral tears on preoperative magnetic resonance scans and had complaints of instability even during daily activities. Results: The mean passive shoulder abduction was 155 (145-170) degrees and mean external rotation was measured 80 (60-90) degrees. The mean preoperative Rowe score was 42 points, while the postoperative score was 89.1 points at the last time follow up. The difference was statistically significant (p <0.05). The Constant score was 52 preoperatively and increased to 85 points after the surgery. The difference was statistically significant (p <0.05). The mean loss of external rotation was observed %28.75 and the last time follow up decreased to %8.2. The difference was statistically significant (p <0.05). All of the patients returned to their daily activities and no dislocation has been occurred. Conclusion: Although, in the past, the results of arthroscopic repair were less satisfactory compared to open and mini open surgery. This condition has changed remarkably. The results of arthroscopic repair in our study were good enough compared to open surgeries. Also in patients who underwent arthroscopic repair, length of hospital stay is shorter, less pain and less scar tissue occurs after the surgery. We believe that, with enhanced experience and advances in arthroscopic repair techniques, arthroscopic treatment may outweigh open surgery.

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Clinical Outcome of Arthroscopic Bankart Repair Combined With Simultaneous Capsular Repair

The American Journal of Sports Medicine ◽

10.1177/0363546516687752 ◽

2017 ◽

Vol 45 (6) ◽

pp. 1289-1296 ◽

Cited By ~ 10

Author(s):

Shigeto Nakagawa ◽

Ryo Iuchi ◽

Tatsuo Mae ◽

Naoko Mizuno ◽

Yasuhiro Take

Keyword(s):

Postoperative Recurrence ◽

Bankart Repair ◽

Level Of Evidence ◽

Old Patients ◽

Glenohumeral Ligament ◽

Capsular Repair ◽

Arthroscopic Bankart Repair ◽

Significant Difference ◽

Competitive Athletes

Background: A capsular tear and humeral avulsion of the glenohumeral ligament lesion are not uncommon findings in association with a Bankart lesion. However, there have been few reports regarding the prevalence of such capsular lesions and the postoperative recurrence after capsular repair. Purpose/Hypothesis: This study investigated the prevalence of capsular lesions and clarified their influence on the postoperative recurrence of instability. In addition, factors were identified that were associated with the occurrence of capsular lesions and the postoperative recurrence of instability. We hypothesized that clinical outcomes would be improved by combining arthroscopic Bankart repair with simultaneous capsular repair. Study Design: Cohort study; Level of evidence, 3. Methods: Capsular lesions were retrospectively examined through operative records, still pictures, and videos in 172 shoulders with traumatic anterior instability. First, the prevalence of capsular lesions and their severity were investigated. Then, postoperative recurrence was determined in shoulders observed for a minimum of 2 years. Finally, factors were assessed that were associated with the occurrence of capsular lesions and the postoperative recurrence of instability. Results: A capsular lesion was recognized in 37 shoulders (21.5%), being severe and mild in 20 and 17, respectively. All were repaired simultaneously with the arthroscopic Bankart procedure. After follow-up for at least 2 years, recurrence of instability was detected in 10 of 34 shoulders (29.4%), including 6 (31.6%) with severe capsular lesions and 4 (26.7%) with mild lesions. The recurrence rate was significantly higher in shoulders with a capsular lesion than in shoulders without a capsular lesion (18 of 120, 15%; P = .013), but there was no significant difference between severe and mild lesions. Regardless of the sport played, capsular lesions were significantly more frequent in patients ≥30 years old, patients with complete dislocation, and patients with a coexisting Hill-Sachs lesion. Postoperative recurrence of instability was significantly more frequent in patients <30 years and competitive athletes. Conclusion: In shoulders undergoing arthroscopic Bankart repair, capsular lesions were often present and were associated with higher postoperative recurrence of instability. While these lesions were more frequent in older patients, postoperative recurrence of instability was more likely in young competitive athletes.

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Arthroscopic Bankart Repair With Remplissage in Comparison to Bone Block Augmentation for Anterior Shoulder Instability With Bipolar Bone Loss: A Systematic Review

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2020.08.033 ◽

2020 ◽

Author(s):

Kyle Gouveia ◽

Syed Kumail Abidi ◽

Saif Shamshoon ◽

Chetan Gohal ◽

Kim Madden ◽

...

Keyword(s):

Systematic Review ◽

Bone Loss ◽

Shoulder Instability ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Bone Block ◽

Arthroscopic Bankart Repair

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Combined subcritical thresholds of glenoid and humeral sided bone loss are predictive of failure after arthroscopic Bankart repair

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00380 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0038

Author(s):

Gillian Kane ◽

Elan Golan ◽

Kevin Wilson ◽

Bryson Lesniak ◽

Ryan Li Albert Lin

Keyword(s):

Bone Loss ◽

Roc Analysis ◽

Bankart Repair ◽

Older Individuals ◽

Index Procedure ◽

Arthroscopic Bankart Repair ◽

Risk Of Failure ◽

Glenoid Track ◽

Independent Risk Factors

Objectives: Glenoid and humeral sided bone loss are both independent risk factors for failure after arthroscopic Bankart repair. The purpose of this study was to determine the combined effect of subcritical levels of humeral and glenoid sided bone loss on failure after arthroscopic Bankart repair. Methods: 171 individuals with minimum 2 years follow up who underwent primary arthroscopic Bankart repair between 2007-2015 were included in this study. Glenoid and humeral sided bone loss were measured using the glenoid track model. Cases were defined as individuals who sustained a subluxation or dislocation event after the index procedure, while controls were defined as individuals who did not. Subjects were stratified by age (20+ versus < 20 years). Receiver operating curves (ROC) were generated to determine the threshold of glenoid and humeral sided bone loss that could best predict failure. Results: There were 53 cases and 118 controls. Increased glenoid (p < .001) and humeral-sided (p = .013) bone loss independently predicted failure. ROC analysis demonstrated that threshold values of 12% glenoid (AUC = 0.62) and 13 mm humeral (AUC = 0.60) bone loss were predictive of failure. Combined subcritical thresholds of 10% glenoid and 10 mm humeral sided bone loss successfully predicted outcomes of 49/56 (87.5%) individuals over age 20 and 79/117 (67.5%) individuals under age 20. Humeral and glenoid sided bone loss had an additive effect on risk of failure in older individuals while glenoid sided bone loss was primarily responsible for failure in younger individuals. Conclusion: Both glenoid and humeral sided bone loss are predictive of failure after arthroscopic Bankart repair. Combined subcritical thresholds of glenoid and humeral sided bone loss accurately predict failure, particularly in individuals over the age of 20. These results suggest that individuals with subcritical bipolar lesions may be at higher risk of failure after arthroscopic Bankart repair than previously thought. [Table: see text]

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