Bankart Procedure Augmented by Coracoid Transfer for Contact Athletes with Traumatic Anterior Shoulder Instability

Context: Recurrent shoulder instability in young athletes can lead to a spectrum of soft tissue and bony lesions that can be bothersome and/or disabling. Coracoid transfer is a treatment option for athletes with recurrent instability. Objective: To report the rate of return to sport for athletes after coracoid transfer. Data Sources: An electronic search of the literature was performed using the PubMed (MEDLINE) and Cochrane Databases (1966-2018). Study Selection: Studies were included if they evaluated return to sport after treatment with coracoid transfer at a minimum 1-year follow-up. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data were extracted by 2 authors and included study design, level of evidence, patient demographics (number, age, sex), procedure performed, duration of clinical follow-up, rate of return to sport, patient-reported outcome measures, reoperations, and complications. Results: Fourteen studies met the inclusion criteria. The rate of return to sport at any level ranged from 80% to 100% in all but 1 study (38%), and the rate of return to the previous level of play ranged from 56% to 95% in all but 1 study (16%). Patients returned to sport at an average of 3.2 to 8.1 months. The average patient-reported outcome scores ranged from 78% to 94% (Rowe), 223.6 to 534.3 (Western Ontario Shoulder Instability Index), and 75% to 90% (subjective shoulder value). The rate of postoperative dislocation ranged from 0% to 14%, and the reoperation rate ranged from 1.4% to 13%. Conclusion: There was a high early rate of return to sport in patients who underwent coracoid transfer for anterior shoulder instability, although patients did not reliably return to the same level of play. The procedure had very favorable outcomes for treatment of instability, with low rates of recurrent dislocation and reoperation.

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Revisiting the Open Bankart Experience

The American Journal of Sports Medicine ◽

10.1177/03635465020300060401 ◽

2002 ◽

Vol 30 (6) ◽

pp. 778-782 ◽

Cited By ~ 40

Author(s):

Lennart Magnusson ◽

Jüri Kartus ◽

Lars Ejerhed ◽

Ingrid Hultenheim ◽

Ninni Sernert ◽

...

Keyword(s):

Shoulder Instability ◽

External Rotation ◽

Constant Score ◽

Surgical Reconstruction ◽

Anterior Shoulder Instability ◽

Reconstruction Procedure ◽

Bankart Procedure ◽

Number Of Patients

Background The open Bankart technique for posttraumatic recurrent anterior instability has become the procedure of choice for patients who do not respond to nonoperative treatment. Hypothesis The open Bankart procedure renders stable and well-functioning shoulders in the long term in a large proportion of patients. Study Design Retrospective follow-up study with independent reexaminers. Methods Fifty-four patients (54 shoulders) with symptomatic, posttraumatic, recurrent anterior shoulder instability underwent an open Bankart reconstruction procedure with suture anchors. All of the patients had a Bankart lesion. Forty-seven patients (87%) were reexamined by independent observers at a mean follow-up period of 69 months (range, 48 to 114). Results The recurrence rate, including both dislocations and subluxations, was 17% (8 of 47). The median Rowe score was 90 points (range, 24 to 100) at the follow-up, and the median Constant score was 88.5 points (range, 41 to 100). External rotation in abduction was a median of 90° (range, 25° to 125°) in the involved shoulders, as compared with 97.5° (80° to 125°) in the noninjured shoulders (P < 0.0001). Conclusions We conclude that, in the long term, the open Bankart procedure resulted in an unexpectedly high number of patients with failure in terms of stability. These results emphasize the importance of performing long-term follow-up studies after surgical reconstruction for unidirectional, posttraumatic, anterior shoulder instability using any type of technique.

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