Abstract
Objectives:
The purpose of this study was to evaluate the clinical and functional outcomes following arthroscopic Bankart repair for the treatment of anterior shoulder instability at long-term follow-up. It was hypothesized that arthroscopic Bankart repair would lead to an excellent clinical and functional outcome with a low rate of instability recurrence.
Methods:
Patients who underwent arthroscopic Bankart repair between October 1996 and April 2002 at a single institution were included. Patient-reported outcome measures (American Shoulder and Elbow Surgeons [ASES] Score, Constant-Murley Score [CMS], Visual Analog Scale for pain [VAS-P] and instability [VAS-I] at rest and during activity, satisfaction with the postoperative result [1-10 scale]), sporting ability as well as the rate of redislocation and reinstability (in patients without redislocations) were evaluated after a minimum follow-up of 20 years.
Results:
In total, 71 patients (78.9% male) were included in this study at a median follow-up of 23 (interquartile range 22-25) years. At the time of surgery, patients were 28.3 ± SD 8.6 years old. Arthroscopic Bankart repair was performed in 19.1% of patients following primary anterior shoulder dislocation and in 80.9% of patients for recurrent anterior shoulder instability. Shoulder function was good to excellent at follow-up (ASES Score: 95.0 [83.0-98.0], CMS: 81.1 ± 15.5). The median pain and instability levels were low both at rest (VAS-P: 1.0 [0-1.0], VAS-I: 0 [0-1.0] and during activity (VAS-P: 1.0 [0-2.0], VAS-I: 2.0 [1.0-4.0]). Overall satisfaction with the postoperative result was high (9.0 [8.0-10]). Postoperative redislocations occurred in 15.4% of patients. Subjective residual instability was reported in 18.2% of the patients that did not suffer a shoulder redislocation, resulting in an overall rate of any instability of 30.8%. Postoperative sporting ability improved in 46.8%, declined in 12.9% and remained unchanged in 40.3% of patients.
Conclusions:
Twenty years postoperatively, arthroscopic Bankart repair was associated with good to excellent shoulder function, low pain levels and high patient satisfaction. About 1 in 3 patients, however, suffered from shoulder instability of whom approximately half reported a redislocation postoperatively.