Evaluation of factors associated with successful 5-year outcomes following arthroscopic Bankart repair in athletes

Abstract

Purpose The purpose of this study was to evaluate the outcomes of athletes 5-years post-operatively following arthroscopic Bankart repair, and to evaluate factors associated with satisfaction and shoulder function, as deined by subjective shoulder value. Methods A retrospective review of athletes who underwent arthroscopic Bankart repair, with a minimum of 5-year follow-up was performed. Recurrence, Visual Analogue Scale (VAS) score, Subjective Shoulder Value (SSV), satisfaction, and whether they would undergo the same surgery again, and rate, level and timing of return to play, and Shoulder Instability-Return to Sport after Injury (SIRSI) score were evaluated. Multi-linear regression models were used to evaluate factors afecting postoperative Satisfaction, and SSV level. Results Overall, 144 athletes who underwent arthroscopic Bankart repair were included, with a mean age of 26.9 years (SD: 8.1), 132 (91.7%) were males, and mean follow-up of 75.7 months. At inal follow up, 82.6% were satisied/very satisied, and the mean SSV was 85.8 (SD: 14.4). Overall, the rate of return to play was 80.5%, with 63.9% returning at the same level at a mean of 6.2 months (SD: 2.7). Overall, there was 18 (12.5%) had recurrent instability, and a further procedure was performed in 15 (10.4%) patients. Linear regression revealed that the SIRSI score (p < 0.0001), SSV (p < 0.0001), VAS (p < 0.0031), no sleep trouble (p = 0.0129) was associated with satisfaction. Logistic regression revealed whether a patient required revision surgery (p = 0.0029), or had re-dislocation (p = 0.0031) was also associated with satisfaction. Linear regression revealed that the SIRSI score (p < 0.0001), VAS score (p < 0.0001), and no sleep trouble (p < 0.0001), were associated with SSV score. Conclusion There was a high rate of satisfaction at 5-year follow-up, with excellent patient-reported outcomes and a high rate of return to play among athletes. However, there was a moderate rate of recurrent instability and further revision surgery. This study identiied that the SIRSI score, VAS score, no sleep trouble and ability to return to play at the same level were associated with both satisfaction and SSV score. Level of evidence III.

Arthroscopic Bankart repair with additional footprint fixation using the double-row technique at the 4 o'clock position anatomically restored the capsulolabral complex and showed good clinical results

“…Arthroscopic Bankart repair (ABR) using suture anchors is a common surgical treatment for recurrent anterior shoulder instability. Many surgeons have performed ABR in which the labrum, including the anteroinferior glenohumeral ligament (AIGHL), is repaired at the articular edge for patients with small or no bone defects [1][2][3], and it has been found to improve pain and functional outcomes in the majority of patients [4,5]. However, some authors reported that approximately one-third of athletes did not return to their preinjury level of sports performance [6], and Miura et al demonstrated that ABR still resulted in a signiicantly high rate of recurrent instability, such as subluxation or apprehension [7].…”

Return to play following operative management of anterior shoulder instability in overhead athletes—A systematic review

“…RTP is often an athlete's primary concern with anterior shoulder instability. Indeed, Hurley et al 39 found that the biggest predictor of satisfaction at 5-year post-surgical intervention was the ability to RTP. Overall, we found high rates of return to sports irrespective of surgical technique ranging from 70% to 86% with mean times of RTP of 5 to 7 months.…”

Patients Report A Positive Experience on Social Media After Bankart Repair

“…8 In 2021, Hurley et al followed 144 patients for a 5-year follow-up and showed 82.6% of patients were satisfied/very satisfied with Bankart Repair. 9 However, these studies are limited by smaller cohort sizes. Comparatively, our study demonstrated that 52% of Instagram posts had a positive tone.…”

“…7 In 2017, Ramkumar et al analyzed 3,145 posts related to ACL reconstruction, which were made by patients, surgeons, and hospitals. 9 The most common types of content were personal recovery stories (92% of overall posts), with an emphasis on wound appearance, the rehabilitation process, and return to play. 11 These results differ from our study, as only 2.5% of patients posted about their wound appearance.…”