The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients

Abstract

This study evaluated the surgical outcomes of young active patients with arthroscopic Bankart repair within 1 month after first-time anterior shoulder dislocation. From July 2002-October 2004, patients presented with first-time traumatic anterior shoulder dislocation and treated with arthroscopic stabilization within 1 month of injury were retrospectively reviewed. Magnetic resonance imaging and computed tomography were performed before the operation in all cases. Cases with contralateral shoulder multidirectional instability or glenoid bone loss of more than 30% on preoperative computed tomography on the injury side were excluded. All patients were treated with arthroscopic Bankart repair, using metallic suture anchors or soft tissue bio-absorbable anchors by a same group of surgeons and followed the same rehabilitation protocol. Recurrence, instability signs, range of motion, WOSI score, Rowe score and complications were assessed. Thirty-eight patients were recruited: the average age was 21 (16-30). All patients had definite trauma history. Radiologically, all patients had Bankart/Hill-Sachs lesion. All the operations were done within 1 month after injury (6-25 days). The average hospital stay was 1.2 days (1-5 days). The average follow-up was 28 months (24-48 months). There were two cases of posttraumatic re-dislocation (5.2%). The average external rotation lag was 5 degrees (0-15) in 90 degrees shoulder abduction when compared with contralateral side. 95% of patients had excellent or good Rowe score. The average WOSI score was 83%. There was one case of transient ulnar nerve palsy and one case of superficial wound infection. This study concluded that immediate arthroscopic Bankart repair with an accelerated rehabilitation program is an effective and safe technique for treating young active patients with first-time traumatic anterior shoulder dislocation.

How Does External Rotation Bracing Influence Motion and Functional Scores After Arthroscopic Shoulder Stabilization?

“…Kim et al [10] reported that a series of 167 patients who underwent arthroscopic Bankart repair had an average final ASES score of 91.9, with 78% of patients having an excellent Rowe score and a 4% rate of recurrent instability at 2-to 6-year followup. Another series by Law et al [13] of 38 patients with an average age of 21 years at mean 28 months after arthroscopic Bankart repair for anterior shoulder instability recorded an average WOSI score of 83%, which is similar to our mean WOSI of 86.8%. In a series of 18 patients with a mean age of 26.8 years, Marquardt et al [16] reported a mean ASES score of 92.1 at mean 8.7 years after surgery.…”

“…The frequency of recurrent instability in our study seems comparable to other published series of arthroscopic instability procedures in which a simple sling was used [10,13,16], but without a head-to-head comparison in the setting of a single study, this inference should be interpreted cautiously.…”

Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment

“…In people younger than 25 years of age, the recurrence rate following conservative management has been reported to be between 60 and 90% [37]. Therefore, there is an increasing trend to treating this group of patients operatively, even after their first traumatic anterior shoulder dislocation [38][39][40]. Contraindications to surgical treatment may include brachial plexus and axillary nerve injuries, deltoid dysfunction and infections [14].…”

Arthroscopic repair of isolated type II superior labrum anterior–posterior lesion

“…In the past decade, while more and more studies investigated the pathologies and treatment, ten types of SLAP lesions have been identified [3,12,15,17,18]. Among the ten types of SLAP lesions, type II lesion is the most common one, which is defined by ''superior labral fraying with stripping of the superior part of the labrum and attached biceps tendon from the underlying glenoid cartilage'' [3,17].…”