Restoration of joint congruency and the glenoidal labrum after arthroscopic revision Bankart repair: a MRI match-paired analysis comparing primary Bankart repair and the uninjured labrum

Abstract

Case series.

Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability After a Failed Arthroscopic Soft-Tissue Repair Yields Comparable Failure Rates to Primary Bankart Repair: A Systematic Review

“…The most frequent complication was recurrent instability (19.9%; N = 56). Recurrent instability was defined as a postoperative dislocation in 4 studies [15,35,40,44], a traumatic event requiring surgical intervention in 2 studies [6,12], and a subluxation or dislocation in 2 studies [3,16]. Other common complications included osteoarthritis (6.8%; N =19), persistent postoperative apprehension (2.5%; N = 7), and traumatic fracture of the glenoid (0.4%; N = 1; Table 2).…”

“…Of the studies that reported a mean of anchors used, 1 study (3.9%; N = 11) reported a mean of 2.5 anchors [40]; 1 study (3.6%; N = 10) reported a mean of 2.7 (range: 2-3) anchors [15]; 1 study (11.4%; n = 32) reported a range of 3 to 5 anchors used [3]; 1 study (2.1%; [42] 19 recurrent instability Buckup et al [6] 3 re-dislocation 2 persistent apprehension Bartl et al [3] 4 recurrent instability Ryu and Ryu [40] 1 recurrent instability Barnes et al [2] 1 persistent apprehension Neri et al [35] 2 re-dislocation Stein et al [44] 1 re-dislocation 4 persistent apprehension 1 traumatic failure of the glenoid Frank et al [16] 12 recurrent instability Franceschi et al [15] 1 recurrent instability N = 6) reported a range of 3 to 6 anchors used [35]; and 1 study (2.5%; N = 7) reported a minimum of 3 anchors [20]. A total of 7 studies (N = 109) reported positioning of the anchors [3,6,15,20,35,40,44]. Of these, 2 studies (15.3%; N = 43) placed the most inferior anchor at the 4:30 o'clock position and the superior anchor at the 3:00 o'clock position [6,44].…”

Outcomes After Revision Anterior Shoulder Stabilization: A Systematic Review

“…Furthermore, postoperative external rotation deficits at 0° and 90° of abduction were identified in revision cases compared with primary arthroscopic repair cases. 47…”

“…There were 4 included studies that compared revision arthroscopic stabilization with primary arthroscopic stabilization, with variable reported outcomes. 26,31,33,47 Krueger et al 26 compared 20 revision with 20 primary arthroscopic shoulder stabilization cases and reported no significant difference in the number of recurrent postoperative dislocations, although the apprehension sign was positive in 2 of the patients in the revision group. Of note, however, the number of preoperative dislocations for the primary arthroscopic stabilization group was 8.7 versus 9.8 for the revision arthroscopic stabilization group.…”

“…The findings suggested that arthroscopic repair in the setting of even moderate bone loss led to higher recurrent instability rates than primary stabilization, despite improved clinical outcome scores. 31 Stein et al 47 retrospectively evaluated 25 revision arthroscopic Bankart repair cases and compared 23 of these with matched primary Bankart repair cases (based on sex, age, and follow-up time). The study reported a 20% failure rate for the revision cases (4% redislocation and 16% positive apprehension), with 1 patient requiring subsequent glenoid augmentation and another requiring arthroscopic osteosynthesis for a traumatic glenoid fracture.…”