Recurrence After Arthroscopic Labral Repair for Traumatic Anterior Instability in Adolescent Rugby and Contact Athletes

Torrance, Emma; Clarke, Ciaran John; Monga, Puneet; Funk, Lennard; Walton, Michael

doi:10.1177/0363546518794673

Cited by 55 publications

(79 citation statements)

References 24 publications

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“…Regarding recurrences, several previous authors have reported a high risk of recurrences associated with Bankart repair in contact athletes. 11 , 18 , 19 Alkaduhimi et al. 19 in a recent systematic review evaluated the redislocation risk after arthroscopic Bankart repair in collision athletes.…”

Section: Discussionmentioning

confidence: 99%

High Variability in Functional Outcomes and Recurrences Between Contact Sports After Arthroscopic Bankart Repair: A Comparative Study of 351 Patients With a Minimum 3-Year Follow-Up

Rossi

Tanoira

Gorodischer

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To compare return to sports, functional outcomes, and complications of a consecutive series of contact athletes with anterior glenohumeral instability treated with isolated arthroscopic Bankart repair for isolated anterior instability. Methods Between January 2008 and December 2016, 351 competitive athletes who participated in contact or collision sports underwent isolated arthroscopic Bankart repair at our institution (rugby n = 105, soccer n = 90, martial arts n = 36 boxing n = 28, field hockey n = 30, handball n = 31, and basketball n = 31). Return to sports, the Rowe score, and the Athletic Shoulder Outcome Scoring System (ASOSS) score were used to assess functional outcomes. Complications also were evaluated. Results The mean follow-up period was 66.7 months (range, 36-148 months) and the mean age of the 351 patients was 21.3 years (range, 17-30 years).Overall, 309 patients (88%) were able to return to sports, and 284 (81%) returned at the same level as before the injury. The mean time to return to sports was 5.3 months. The rate of return to sports, the level achieved by the patients, and time to return to sports varied significantly between sports. The Rowe and ASOSS scores showed statistical improvement after operation ( P < .001). The ASOSS score varied significantly between sports ( P < .001). There were 40 recurrences (11.3%), 7 complications (2%) and 21 patients (6%) underwent revision surgery. There was a significant difference in the rate of recurrences and revisions between the different contact sports. Conclusions In athletes with glenohumeral instability who undergo isolated arthroscopic Bankart repair for isolated anterior instability, there is great variability in the rate of return to sport at the same level, in shoulder performance after returning to competition, and in the postoperative recurrence rates. Due to the high variability found in our study, results after arthroscopic Bankart repair in contact athletes should not be reported globally by including the different sports under the “collision or contact sports” label. Level of Evidence Retrospective Case Series; Level of evidence, 4.

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Section: Discussionmentioning

confidence: 99%

High Variability in Functional Outcomes and Recurrences Between Contact Sports After Arthroscopic Bankart Repair: A Comparative Study of 351 Patients With a Minimum 3-Year Follow-Up

Rossi

Tanoira

Gorodischer

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…For example, when a retear occurs, revision surgery is sometimes challenging because the previous anchors are difficult to remove with limited room for new anchor insertion. In addition, the cost of multiple anchors is high, and anchor dislodgement and bone osteolysis of glenoid bone (6,20). In this present study on both all-soft suture anchor and conventional metal anchor with arthroscopic labral repair in traumatic anterior shoulder instability, there were no reported intraoperative, perioperative, or postoperative complications, such as persistent shoulder pain, infection, wound problems, recurrence, stiffness, neurological damage, arthritic changes and anchor pull-out.…”

Section: Discussionmentioning

confidence: 53%

“…Although arthroscopic surgery suture anchors continue to evolve, the complications of bankart repair have not been completely solved (6,(20)(21)(22)(23). Metal suture anchor fixation is frequently used although it causes complications such as arthritis, pull-out, and osteolysis (10,11,14).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical and Functional Results After Arthroscopic Bankart Repair With The Conventional Metal Anchor and The All-Soft Suture Anchor

Arıcan¹,

Turhan²

2019

Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

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Aim: To compare the clinical results after arthroscopic bankart repair with all-soft suture anchor and conventional metal anchor in physically active patients with traumatic anterior shoulder instability. Material and Methods: A total of 32 patients who met eligibility criteria were included between 2016 and 2017 years, for arthroscopic bankart repair in a single orthopedic department. The patients were examined into 2 groups as 17 underwent repair with 1.8 mm all-suture anchor with 2 (5 metric) Hi-Fi® sutures (Y-knot® flex, Conmed, USA) (group 1), and 15 underwent repair with conventional titanium 3.5 mm Suture Anchors with two preloaded ultrabraid sutures (TWINFIX, Smith & Nephew) (group 2). Clinical and functional outcomes were assessed pretreatment, and final follow-up using the American shoulder and Elbow surgeons (ASES) score and the ROWE score. Results: The mean ASES score increased significantly in group 1 from 35.62±8.46 to 88.86±6.23 (p=0.0001) and had increased significantly in group 2 from 41.15±14.51 to 91.15±7.54 (p=0.0001). The mean ROWE score had increased significantly in group 1 from 48.82±11.25 to 85.00±10.00 (p=0.0001) and had significantly increased in group 2 from 45.67±9.61 to 87.67±10.15 (p=0.0001). There was no significant difference between the mean ASES scores of group 1 and group 2 (p=0.192, p=0.353), and also no significant difference between the mean ROWE scores of group 1 and group 2 (p=0.404, p=0.461) at pretreatment and final follow-up respectively. Conclusion: Arthroscopic bankart repair with an all-soft suture anchor demonstrated comparable clinical and functional results as the conventional metal suture anchor at short term follow-up.

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“…19 Despite surgical reconstruction of injured structures, a relatively high frequency of further shoulder instability occurs, most notably in young athletes in contact sports (5.9%-51%). 2,92,107 It remains unclear when athletes can safely return to sport (RTS) after glenohumeral joint stabilization and what criteria surgeons and clinicians should use to guide their decision making. Furthermore, the decision to return an athlete to competition has significant implications ranging from the safety of the athlete to performance factors and litigation issues.…”

mentioning

confidence: 99%

Outcome Measures After Shoulder Stabilization in the Athletic Population: A Systematic Review of Clinical and Patient-Reported Metrics

Fanning

Maher

Cools

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Athletic endeavor can require the “athletic shoulder” to tolerate significant load through supraphysiological range and often under considerable repetition. Outcome measures are valuable when determining an athlete’s safe return to sport. Few data are available to guide a clinician’s choice from the variety of measures available. Purpose: To describe the use of quantifiable objective outcome measures and patient-reported outcome tools after glenohumeral joint stabilization, specifically in an athletic population. The secondary aim of our study was to assess whether the method of measurement used was clearly described and standardized to aid clinical interpretation. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of MEDLINE, Scopus, SPORTDiscus, and Web of Science databases was performed in December 2018 based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After the application of selection criteria, a full review of identified papers, and screening of reference lists, a total of 62 studies were included in the review. All studies were independently appraised for quality, predefined data fields were populated and cross-checked for accuracy, and results were then summarized from these data fields. Results: Of the 62 included studies, 94% used a quantifiable objective clinical outcome. A majority (85%) of the studies measured range of motion, 21% recorded muscle strength, 5% measured electromyographic activity, 5% examined shoulder kinematics, and 3% assessed joint proprioception after surgery. However, only 18% of the studies clearly described a standardized method of measuring the outcome. Nearly all (95%) of the studies used at least 1 patient-reported outcome measure. The Rowe score was most commonly used (35%). Conclusion: We must standardize and clearly describe the use of quantifiable objective outcome measures to aid clinical interpretation. A concerted effort should also be made to standardize the use of patient-reported outcome tools after shoulder stabilization in the athletic population.

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Recurrence After Arthroscopic Labral Repair for Traumatic Anterior Instability in Adolescent Rugby and Contact Athletes

Cited by 55 publications

References 24 publications

High Variability in Functional Outcomes and Recurrences Between Contact Sports After Arthroscopic Bankart Repair: A Comparative Study of 351 Patients With a Minimum 3-Year Follow-Up

High Variability in Functional Outcomes and Recurrences Between Contact Sports After Arthroscopic Bankart Repair: A Comparative Study of 351 Patients With a Minimum 3-Year Follow-Up

Comparison of Clinical and Functional Results After Arthroscopic Bankart Repair With The Conventional Metal Anchor and The All-Soft Suture Anchor

Outcome Measures After Shoulder Stabilization in the Athletic Population: A Systematic Review of Clinical and Patient-Reported Metrics

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