Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

Yon, Chang-Jin; Cho, Chul-Hyun; Kim, Du Hwan

doi:10.3390/jcm9113418

Cited by 9 publications

(10 citation statements)

References 53 publications

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“…Another systematic review revealed a recurrence rate of 14% to 21% after primary ACR, 27 and Murphy et al 31 reported rates of 31.2% for recurrent instability and 17% for overall revision at >10-year follow-up after primary ACR. The present study revealed a positive apprehension sign in 17.4% of patients in the revision group, which agrees with the results reported by Yon et al, 52 although various studies 2,6,17 in that systematic review excluded patients with a glenoid bone defect of >20%. In the present study, there was no dislocation, and good results were obtained.…”

Section: Discussionsupporting

confidence: 93%

“…Yon et al 52 reviewed 14 articles and 339 patients who underwent revision ACR and reported that 15.3% of patients experienced recurrent instability, including positive apprehension signs and dislocations. Another systematic review revealed a recurrence rate of 14% to 21% after primary ACR, 27 and Murphy et al 31 reported rates of 31.2% for recurrent instability and 17% for overall revision at >10-year follow-up after primary ACR.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Jeon

Kim²,

Rhee

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The optimal revision surgery for failed primary arthroscopic capsulolabral repair (ACR) has yet to be determined. Revision ACR has shown promising results. Purpose: To compare the functional, strength, and radiological outcomes of revision ACR and primary ACR for anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between March 2007 and April 2017, a total of 85 patients underwent ACR (revision: n = 23; primary: n = 62). Functional outcome scores and positive apprehension signs were evaluated preoperatively, at 1 year, and then annually. Isokinetic internal and external rotation strengths were evaluated preoperatively and at 1 year after surgery. Results: The mean follow-up was 36.5 ± 10.2 months (range, 24-105 months). There was no significant difference between the revision and primary groups in the glenoid bone defect size at the time of surgery (17.3% ± 4.8% vs 15.4% ± 5.1%, respectively; P = .197). At the final follow-up, no significant differences were found in the American Shoulder and Elbow Surgeons score (97.6 ± 3.1 vs 98.0 ± 6.2, respectively; P = .573), Western Ontario Shoulder Instability Index score (636.7 ± 278.1 vs 551.1 ± 305.4, respectively; P = .584), or patients with a positive apprehension sign (17.4% [4/23] vs 11.3% [7/62], respectively; P = .479) between the revision and primary groups. There was no significant difference between the revision and primary groups for returning to sports at the same preoperative level (65.2% vs 80.6%, respectively; P = .136) and anatomic healing failure at 1 year after surgery (13.0% vs 3.2%, respectively; P = .120). Both groups recovered external rotation strength at 1 year after surgery (vs before surgery), although the strength was weaker than in the uninvolved shoulder. In the revision group, a larger glenoid bone defect was significantly related to a positive apprehension sign (22.0% ± 3.8%) vs a negative apprehension sign (16.0% ± 3.2%; cutoff = 20.5%; P = .003). Conclusion: In patients with moderate glenoid bone defect sizes (10%-25%), clinical outcomes after revision ACR were comparable to those after primary ACR. However, significant glenoid bone loss was related to a positive remaining apprehension sign in the revision group. Surgeons should consider these findings when selecting their revision strategy for patients with failed anterior shoulder stabilization.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Jeon

Kim²,

Rhee

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…A recent review found that revision anterior shoulder stabilization techniques such as arthroscopic, open Bankart, or bony procedures yielded satisfactory outcomes, with the lowest recurrent instability rate for patients undergoing the Latarjet procedure [ 28 ]. Another review found a complication and recurrence rate of 18.0% and 15.3%, respectively, for patients undergoing arthroscopic revision Bankart repair [ 50 ]. The authors noted that postoperative improvements are found if patients are selected carefully (ie, minimal glenoid bone loss and Hill-Sachs lesion) [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is extensive literature reporting the effectiveness of revision anterior shoulder stabilization techniques, particularly open revision Bankart/Latarjet repair following failed arthroscopic Bankart procedures [ 9 , 14 , 28 , 36 ]. There has also been increasing interest in the use of an arthroscopic Bankart repair in the revision setting in mixed populations (ie, failed open or arthroscopic index procedure) [ 1 , 50 ]. However, there exists a dearth of evidence on arthroscopic revision Bankart procedures for recurrent anterior shoulder instability following a failed primary arthroscopic Bankart repair.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background: The management of recurrent instability after arthroscopic Bankart repair remains challenging. Of the various treatment options, arthroscopic revision repairs are of increasing interest due to improved visualization of pathology and advancements in arthroscopic techniques and instrumentation. Purpose: We sought to assess the indications, techniques, outcomes, and complications for patients undergoing revision arthroscopic Bankart repair after a failed index arthroscopic soft-tissue stabilization for anterior shoulder instability. Methods: We performed a systematic review of studies identified by a search of Medline, Embase, and PubMed. Our search range was from data inception to April 29, 2020. Outcomes include clinical outcomes and rates of complication and revision. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. Results: Twelve studies were identified, comprising 279 patients (281 shoulders) with a mean age of 26.1 ± 3.8 years and a mean follow-up of 55.7 ± 24.3 months. Patients had improvements in postoperative outcomes (eg, pain and function). The overall complication rate was 29.5%, the most common being recurrent instability (19.9%). Conclusion: With significant improvements postoperatively and comparable recurrent instability rates, there exists a potential role in the use of revision arthroscopic Bankart repair where the glenoid bone loss is less than 20%. Clinicians should consider patient history and imaging findings to determine whether a more rigorous stabilization procedure is warranted. Large prospective cohorts with long-term follow-up and improved documentation are required to determine more accurate failure rates.

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“…Yon CJ et al demonstrate that arthroscopic revision Bankart repair might lead to an improvement in clinical outcomes and reasonable satisfaction with proper patient selection [ 14 ].…”

Section: Introductionmentioning

confidence: 99%