Long-term, Prospective, Multicenter Study of Isolated Bankart Repair for a Patient Selection Method Based on the Instability Severity Index Score

Thomazeau, H.; Langlais, Tristan; Hardy, Alexandre; Curado, Jonathan; Herisson, Olivier; Mouton, Jordane; Charousset, Christophe; Courage, Olivier; Nourissat, Geoffroy

doi:10.1177/0363546519833920

Cited by 37 publications

(44 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previously, Kim et al 11 reported an 8.8% recurrence rate. The recurrence rates describe by Kin compared favorably with prior literature on arthroscopic labral repair using single-loaded anchors, with reported recurrence rates of 17%, 16 23%, 27 26%, 2 29%, 3 44%, 18 and 51%. 28 Recurrence rates are multifactorial and influenced by glenoid bone loss.…”

Section: Discussionsupporting

confidence: 53%

Double-loaded suture anchors in the treatment of anteroinferior glenohumeral instability

Chalmers¹,

Hillyard²,

Kawakami³

et al. 2020

JSES International

View full text Add to dashboard Cite

Hypothesis The purpose of this study was to determine the clinical outcomes of arthroscopic labral repair for anteroinferior glenohumeral instability with the use of double-loaded suture anchors. Methods This study evaluated a series of consecutive patients treated after the senior author changed from single- to double-loaded suture anchors for the treatment of anteroinferior glenohumeral instability with a minimum follow-up period of 2 years. We collected the following outcomes at final follow-up: visual analog scale pain score, Simple Shoulder Test score, American Shoulder and Elbow Surgeons score, and instability recurrence data. Results A total of 41 consecutive patients underwent arthroscopic labral repair with double-loaded anchors, of whom 30 (71%) were able to be contacted at a minimum of 2 years postoperatively. These patients included 4 contact or collision athletes (13%). The patients had an average of 12 ± 13 prior dislocations over an average period of 56 ± 57 months preoperatively. Mean glenoid bone loss measured 16% ± 10%, and 67% (18 of 27 patients) had glenoid bone loss ≥ 13.5%. Intraoperatively, 3.2 ± 0.4 anchors were used. No posterior repairs or remplissage procedures were performed. At an average of 6.7 ± 2.7 years' follow-up, the visual analog scale pain score was 0.8 ± 1.4; Simple Shoulder Test score, 11 ± 2; and American Shoulder and Elbow Surgeons score, 90 ± 14. Patients with bone loss < 13.5% had a 0% redislocation rate and 11% subluxation rate, whereas those with bone loss ≥ 13.5% had a 6% reoperation rate, 22% redislocation rate, and 22% subluxation rate. Conclusion Arthroscopic labral repair with double-loaded anchors provides satisfactory clinical results at early to mid-term outcome assessment when glenoid bone loss is <13.5%.

show abstract

Section: Discussionsupporting

confidence: 53%

Double-loaded suture anchors in the treatment of anteroinferior glenohumeral instability

Chalmers¹,

Hillyard²,

Kawakami³

et al. 2020

JSES International

View full text Add to dashboard Cite

show abstract

“…Initially, a score >6 was used to recommend a Latarjet. In later work, Phadnis et al 29 recommended lowering this threshold to 3, and more recently Thomazeau et al 34 reported that this threshold should even be lowered to 2. In a study of 141 consecutive patients, Phadnis et al showed that those with an Instability Severity Index Score ≤3 had a 4% risk of failure, as compared with a 70% risk of failure if the score was ≥4.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Latarjet Procedure for the Treatment of Chronic Anterior Shoulder Instability: Patients With Prior Arthroscopic Bankart Repair Versus Primary Cases

Werthel

Sabatier²,

Schoch

et al. 2019

Am J Sports Med

Self Cite

View full text Add to dashboard Cite

Background: It remains unclear whether results differ between a Latarjet procedure performed after a failed arthroscopic Bankart repair and one performed as the primary operation. Purpose: To compare the postoperative outcomes of the Latarjet procedure when performed as primary surgery and as revision for a failed arthroscopic Bankart repair. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior shoulder instability. Patients were separated into 2 groups depending on if the Latarjet procedure was performed after a failed arthroscopic Bankart repair (group 1) or as the first operation (group 2). Outcome measures included recurrent instability, reoperation rates, complications, pain, Walch-Duplay scores, and Simple Shoulder Test. Results: A total of 308 patients were eligible for participation in the study; 72 (23.4%) did not answer and were considered lost to follow-up, leaving 236 patients available for analysis. Mean follow-up was 3.4 ± 0.8 years. There were 20 patients in group 1 and 216 in group 2. Despite similar rates of recurrent instability (5.0% in group 1 vs 2.3% in group 2; P = .5) and revision surgery (0% in group 1 vs 6.5% in group 2; P = .3), group 1 demonstrated significantly worse pain scores (2.56 ± 2.7 vs 1.2 ± 1.7; P = .01) and patient-reported outcomes (Walch-Duplay: 52 ± 25.1 vs 72.2 ± 25.0; P = .0007; Simple Shoulder Test: 9.3 ± 2.4 vs 10.7 ± 1.9; P = .001) when compared with those patients undergoing primary Latarjet procedures. Conclusion: Functional outcome scores and postoperative pain are significantly worse in patients undergoing a Latarjet procedure after a failed arthroscopic Bankart repair when compared with patients undergoing primary Latarjet. The assumption that a failed a Bankart repair can be revised by a Latarjet with a similar result to a primary Latarjet appears to be incorrect. Surgeons should consider these findings when deciding on the optimal surgical procedure for recurrent shoulder instability.

show abstract

“…Six risk factors were identified that predict an increased recurrence rate after arthroscopic Bankart repair: a patient age under 20 years at the time of surgery, sports involving contact or forced overhead activity, practice at a competitive level, shoulder hyperlaxity, a superior Hill-Sachs lesion visible in external rotation, and a loss of contour of the inferior glenoid on a plain AP radiograph. These factors, which The ISI score has been validated in Canada and Europe through many studies with consistent results, [5][6][7][8][9][10][11][12] confirming the increased failure rate with a higher score (a score >6 points means a recurrence risk of 70%). The failure rate also increases with longer follow-up, with an average delay before recurrence of 3 years.…”

Section: Which Patients Are Likely To Undergomentioning

confidence: 86%

Editorial Commentary: Should We Condemn the Shoulder Instability Severity Index Scoring System? Not at All!... Can We Improve Its Radiographic Component? Yes, We Can!

Boileau¹,

Balg

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Is patient selection necessary in shoulder instability surgery? Absolutely. The risk-benefit discussion that the surgeon must have with the patient before proposing an arthroscopic Bankart repair remains crucial to provide informed consent. The most important preoperative risk factors are incorporated in the instability severity index (ISI) score to assist surgeons in the decision-making process. This 10-point score is based on factors derived from a preoperative questionnaire, physical examination, and simple plain radiographs. Using this score at the first visit, the surgeon can explain to the patient and family why a Bankart repair may be contraindicated and why other surgical options may be more suitable. A recent study found that the ISI score has no limited predictive value when applied in a preselected population of military patients without severe bone loss or hyperlaxity. This is not surprising because the authors analyzed a preselected patient population with lower risk than the general population. The value of the ISI scoring system relies on the fact that this tool has been developed after evaluation of arthroscopic Bankart repair in an unselected patient population and that there is no need for sophisticated imaging studies to make the decision. This scoring system should not be condemned but complemented with preoperative advanced imaging studies (computed tomography [CT] scanning or magnetic resonance imaging) to assess the severity of the bone lesions more accurately. Today, the choice of the surgical procedure depends not only on the clinical risk factors included in the ISI score (age, type of sports, level of practice, hyperlaxity) but also on the presence, location and size of bony lesions, as identified and measured on advanced CT scanning images.

show abstract

Long-term, Prospective, Multicenter Study of Isolated Bankart Repair for a Patient Selection Method Based on the Instability Severity Index Score

Cited by 37 publications

References 15 publications

Double-loaded suture anchors in the treatment of anteroinferior glenohumeral instability

Double-loaded suture anchors in the treatment of anteroinferior glenohumeral instability

Outcomes of the Latarjet Procedure for the Treatment of Chronic Anterior Shoulder Instability: Patients With Prior Arthroscopic Bankart Repair Versus Primary Cases

Editorial Commentary: Should We Condemn the Shoulder Instability Severity Index Scoring System? Not at All!... Can We Improve Its Radiographic Component? Yes, We Can!

Contact Info

Product

Resources

About