Risk Factors for Recurrence of Shoulder Instability After Arthroscopic Bankart Repair

Hill-Sachs lesion is not a significant prognostic factor for recurrence of shoulder redislocation after arthroscopic Bankart repair

“…The authors observed that engaging HSs were located more laterally and inferiorly than those not engaging 6. Engaging HSs were investigated and found to lead to recurrent instability and a high rate of failure when treated with ABR alone 5 58. In 2007, Yamamoto et al postulated the concept of the glenoid tracking.…”

Review of Arciero's article (1994) on arthroscopic Bankart repair versus non-operative treatment for acute, initial anterior shoulder dislocations: does the same hold true in 2016?

“…Boileau et al 60 found that age, gender and sports participation did not contribute to recurrent instability after arthroscopic stabilisation. On multivariate analysis, anterior laxity, attenuation of the inferior glenohumeral ligament and >25% bone loss of the glenoid surface led to 75% rate of recurrence.…”

“…Conversely, recurrence rates were 10% for patients who scored ≤6 and 5% for patients who scored ≤3. In their previous study,60 the majority of the patients who failed initial surgical stabilisation underwent revision with a Latarjet procedure, which the authors now recommend for high-risk patients who present with ISIS >6 instead of arthroscopic Bankart repair for index surgery. In a case–control study, ISIS was retrospectively assessed on a series of patients who either had success or failure of arthroscopic stabilisation to calculate its sensitivity, specificity and positive and negative predictive values 62.…”

“…The development of suture anchors has improved arthroscopic outcomes to be comparable to open surgery. More than three suture anchors are currently recommended for fixation 60. Several randomised controlled trials have demonstrated superior outcomes with arthroscopic stabilisation compared with non-operative treatment 14 15 17 18.…”

Shoulder instability: State of the Art

“…Furthermore, the role of humeral-sided bone defects in glenohumeral instability continues to be elucidated in biomechanical and clinical studies, as several authors have described the reciprocal pathomechanic relationship between these ‘bipolar’ lesions 18 23. HS lesions that engage the glenoid destabilise the shoulder through increasing degrees of abduction and external rotation.…”