Evaluation of Results of Arthroscopic Bankart Repair for Post Traumatic Anterior Shoulder Instability

Abstract

BACKGROUND:The study was to evaluate the surgical outcomes of arthroscopic repair of post-traumatic Bankart lesions with the use of suture anchors. Patients with >20% bony lesions, SLAP (superior labral tear from anterior to posterior) lesions and multi-directional instability were excluded. The patients were followed up for a period of minimum 4 years. MATERIALS AND METHODS: We evaluated the results of arthroscopic Bankart repair with use of suture anchors in 35 patients with traumatic recurrent anterior instability of the shoulder. The mean age at operation was 25.71 years. The patients were evaluated pre-operatively and at follow-up using the UCLA (University of California Los Angeles) shoulder scoring system and the modified Rowe scores, which were 6.2 and 29.3 respectively pre-operatively. RESULTS: The UCLA shoulder scoring system and the modified Rowe scores at follow-up were 32 and 72.57 respectively and both improvements were significant. The Modified Rowe Shoulder Scoring System showed 14 patients having excellent results, 12 patients good, 6 patients fair and 3 patients with poor results. One patient had subluxation and another had positive apprehension test. Five patients had discomfort/pain with arm in abducted and externally rotated position but negative apprehension test. Remaining 28 patients had negative apprehension test; no subluxation. Significant improvements occurred for each motion tested for each follow up visit. CONCLUSION: We conclude that arthroscopic Bankart lesion repair with suture anchors is an effective surgical technique for the treatment of an isolated Bankart lesion having good results with respect to pain relief, stability and function. KEYWORDS: Arthroscopic Bankart repair, Anterior shoulder instability, UCLA (University of California Los Angeles) shoulder rating scale. INTRODUCTION:The shoulder, by virtue of its anatomy and biomechanics, is one of the most unstable and frequently dislocated joints in the body, accounting for nearly 50% of all dislocations. According to one estimate, up to 96% of acute shoulder dislocations were traumatic in origin. (1) Anterior instability is the most common form of shoulder instability. (2) Recurrent anterior shoulder instability results in a functional disability for the patient, in terms of both shoulder function and general health status. (3) The use of arthroscopy has improved the recognition of pathologic findings in shoulder instability and allowed a better understanding of the etiology of instability and the correlation between symptom and lesion patterns.Arthroscopic treatment of shoulder instability due to Bankart lesion introduced some advantages compared with open Bankart lesion repair procedure. The Arthroscopic method offers a less invasive technique of Bankart repair.

Functional outcome of arthroscopic Bankart repair in post-traumatic recurrent shoulder dislocation in a private tertiary care teaching hospital in eastern India

“…Study by Mishra et al in New Delhi (India) had 2 and by Chandra et al had 1 patient with apprehension post-operatively. 25,26 The mean post-operative total Rowe score in our study was 94.20 which is almost similar to studies performed by Kalkar et al, Jadhav et al and Parmar et al in having a total Rowe score of 95.5, 95.63 and 94.16 post-operatively respectively. 21,27,28 In this study, out of 37 patients, 32 (86.5%) came out with excellent results, 2 (5.4%) showed good, 2 (5.4%) showed fair and 1 (2.7%) had poor outcome at the end of 1-year follow-up period.…”