Long-term outcomes of arthroscopic Bankart repair: a 10-year follow-up study

TL;DR

A 10-year follow-up study found that arthroscopic Bankart repair has a 28% recurrence rate but remains a reliable long-term treatment for shoulder instability.

Contribution

This study provides long-term outcomes (up to 14 years) of arthroscopic Bankart repair, a procedure for shoulder instability.

Findings

The 10-year recurrence rate of shoulder dislocation after ABR was 28%.

72% of patients returned to sports fully, and patient satisfaction remained high despite some recurrences.

Mild to moderate osteoarthritis was observed in 2 shoulders, but no revision surgeries were needed.

Abstract

Arthroscopic Bankart repair (ABR) is the gold standard for anterior shoulder dislocation, with many studies demonstrating favorable short-term outcomes. However, few reports focus on the long-term outcomes, partly due to a challenge of following up younger patients. This study aims to evaluate the long-term outcomes of ABR.

This study included 32 shoulders (19 males, 13 females; mean age at surgery: 31 years) out of 55 shoulders that underwent ABR at our institution between 2011 and 2019. Inclusion criteria required a minimum follow-up period of 5 years, and data were collected through telephone surveys or direct examinations. The survey assessed recurrent dislocation or subluxation, shoulder pain, apprehension, return to sports (complete, partial, or inability), and revision surgery. Direct examinations included physical assessments and plain x-rays. The Rowe score and Western Ontario Shoulder Instability Index score were assessed. Adjunct data on surgical procedures and intra-articular lesions were also reviewed.

The mean follow-up period was 10 years (range: 6-14 years). Recurrent dislocation occurred in 3 shoulders (10%), and subluxation in 7 shoulders (22%), yielding a total recurrence rate of 28%. Recurrences were associated with sports or traumatic events. Sports return rates were 72% (23 shoulders) for complete return, 16% (5 shoulders) for partial return, and 13% (4 shoulders) for inability (rugby, volleyball, and judo). Shoulder pain (2-3 in numeric rating scale) was reported in 2 shoulders, and apprehension in the abduction and external rotation position was observed in 4 shoulders (13%). The Rowe score significantly improved from 44 ± 8 points (mean ± standard deviation) to 87 ± 21 points (P < .05), and no revision surgeries were performed. Mild to moderate osteoarthritis on X-rays were found in 2 shoulders.

The average 10-year postoperative recurrence rate was 28%, consistent with the previous systematic reviews. While the recurrence rates increased over time, patient satisfaction remained high, and no revision surgeries were required. These findings demonstrate the long-term reliability of ABR for anterior shoulder instability.

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