Arthroscopic Bankart repair for the acute anterior shoulder dislocation: systematic review and meta-analysis

Adam, Mohammed; Attia, Ahmed Khalil; Alhammoud, Abduljabbar; Aldahamsheh, Osama; Dosari, Mohammed Al Ateeq Al; Ahmed, Ghalib

doi:10.1007/s00264-018-4046-0

Cited by 46 publications

(30 citation statements)

References 25 publications

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“…In 2013, Abouali et al reviewed 16 articles and 349 patients who underwent revision arthroscopic Bankart repair and reported a 12.7% rate of recurrent instability [30]. Comparatively, recurrent instability rates after arthroscopic primary Bankart repair for acute shoulder dislocation range from 7.7 to 19.6%; the revision rate was 7.1% [31]. Based on studies observed in more than ten years of follow-up after arthroscopic Bankart repair, the overall rate of recurrent instability was 31.2%, with 16.0% of patients having recurrent dislocations, and the overall revision rate was 17.0% [32].…”

Section: Discussionmentioning

confidence: 99%

Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

Yon

Cho

Kim

2020

JCM

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Although the frequency of arthroscopic revision surgery is increasing in patients with recurrent dislocation after a primary shoulder stabilization, the literature describing arthroscopic revision Bankart repair has been limited. Preferred reporting items for systematic meta-analyses guidelines were followed by utilizing PubMed, EMBASE, Scopus, and Cochrane Library databases. Keywords included shoulder dislocation, anterior shoulder instability, revision surgery, stabilization, and arthroscopic Bankart repair. Quality assessments were performed with criteria from the methodological index for nonrandomized studies (MINORS). A total of 14 articles were included in this analysis. The mean MINORS score was 12.43. A total of 339 shoulders (337 patients) were included (281 males and 56 females). The mean follow-up period was 36.7 months. Primary surgeries were as follows: arthroscopic procedures (n = 172, 50.7%), open procedure (n = 87, 25.7%), and unknown (n = 80, 23.6%). The mean rate of recurrent instability after revision arthroscopic Bankart repair was 15.3% (n = 52), and an additional re-revision procedure was needed in 6.5% of cases (n = 22). Overall, there were 18.0% (n = 61) of complications reported. This systematic review suggests that arthroscopic revision Bankart repair can lead to an improvement in functional outcomes and reasonable patient satisfaction with proper patient selection.

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Section: Discussionmentioning

confidence: 99%

Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

Yon

Cho

Kim

2020

JCM

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“…5,9,26,35,37 Arthroscopic repair is more common, owing to superior patient-reported outcomes and range of motion postoperatively; however, lower recurrence rates are often reported with open approaches. 38 Although a 2018 systematic review by Adam et al 2 reported an average recurrence rate of 13.7% after arthroscopic Bankart repair and a revision rate of 7.1%, rates of recurrence are highly variable, with reported rates ranging from 2% 25,28,34 to 40%. 31,84…”

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confidence: 99%

“…Various factors have been associated with an increased risk of recurrent instability after Bankart repair. These include the total number of instability events before surgery, 2,34,45 placement of anchors, 54 and concomitant injuries present at surgery. 53 Kasik and Saper 33 found a considerable variation in the means of reported clinical outcomes after arthroscopic Bankart repair.…”

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confidence: 99%

Variability of Reporting Recurrence After Arthroscopic Bankart Repair: A Call for a Standardized Study Design

Kennedy

Murphy

Dornan

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: High recurrence rates have been reported after anterior shoulder dislocations, regardless of the treatment utilized. However, the definition of recurrent instability has been inconsistent, making a comparison between studies difficult. Purpose: To report on the nature with which the rate of recurrent instability is reported after arthroscopic Bankart repair, across all levels of evidence, and to analyze factors that may affect the reported rate of recurrence. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed by searching PubMed, the Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov for studies published within the dates of January 2008 and September 2018. Studies in English that reported on the recurrence of instability after arthroscopic Bankart repair for anterior shoulder instability were considered for inclusion in this review. A meta-regression was performed to test for a linear association between the reported recurrence rate and several continuous covariates, including mean age at surgery, mean length of follow-up, attrition rate (loss to follow-up percentage), and percentage of male patients. Results: A trim-and-fill meta-analysis yielded an estimated overall recurrence rate of 17.4% (95% CI, 14.3%-20.9%). There was a significant difference in the recurrence rate depending on the level of evidence (Q(3) = 10.98; P = .012). Significant associations were found with the recurrence rate through the meta-regression, including a negative association with mean age ( P = .009), a positive association with mean follow-up time ( P = .002), and a positive association with attrition rate ( P = .035). Conclusion: A call for standardization is necessary for reporting outcomes of anterior instability after arthroscopic Bankart repair, especially with regard to the reporting of recurrence/failure rates, with careful consideration of the effects that may occur from patient demographics and study design. With no current recommendations for deeming failure, we suggest that all forms of instability be accounted for when determining a failed treatment procedure, with future studies placing an emphasis on greater control of the study design.

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“…[ 17 ] The anterior instability of shoulder joint is the result of primary dislocation, accompanied by the related diseases, for instance, the Bankart disease. [ 18 ] In the shoulder diseases, clinical results may be affected through the biopsychosocial features, patient expectations or the personality traits. No program supported by postdischarge phone is utilized for the shoulder instability.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of a phone assistance nursing program for functional outcomes in patients after shoulder instability surgery

Zheng¹,

Wang²,

Wang³

et al. 2020

Medicine

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Objective: We conduct this research protocol for the assessment of the effect of phone-assisted care programs on functional outcomes in patients receiving shoulder instability surgery. Methods: This is a randomized controlled, single center trial which will be implemented from October 2020 to December 2021. This trial is conducted according to the SPIRIT Checklist of randomized researches. It was authorized via the Ethics Committee of the First People's Hospital of Xiangyang city affiliated to Hubei Medical College (XY234-026). Ninety participants who undergo shoulder instability surgery are analyzed. Patients are randomly divided into control group (standard management group, with 45 patients) and study group (the phone program group, with 45 patients). In control group, the exercises at home are not monitored. Whereas in study group, patients are asked about their at-home activities, and the extra coaching sessions are provided to patients on self-care, exercise guidance, and the importance of exercise at home, and then answers to their questions. The primary outcome is the range of motion of the shoulder joint, and the pain arcs are determined through the range of motion. The extra assessments include the shoulder functional outcome, pain, and the quality of life. All the analysis needed in this study is implemented with SPSS (IBM, Chicago, USA) for Windows Version 19.0. Results: The clinical outcome variables between groups are shown in Table. Conclusion: This investigation can offer a reliable basis for the effectiveness of phone assistance nursing program in patients after shoulder instability surgery. Trial registration number: researchregistry6010

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Arthroscopic Bankart repair for the acute anterior shoulder dislocation: systematic review and meta-analysis

Cited by 46 publications

References 25 publications

Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes

Variability of Reporting Recurrence After Arthroscopic Bankart Repair: A Call for a Standardized Study Design

The efficacy of a phone assistance nursing program for functional outcomes in patients after shoulder instability surgery

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