Outcomes After Arthroscopic Bankart Repair in Adolescent Athletes Participating in Collision and Contact Sports

Abstract

Background:Literature on arthroscopic stabilization in adolescent patients participating in collision and contact sports is limited, as most studies include adolescents within a larger sample group comprised primarily of adults.Purpose:To review the outcomes of arthroscopic Bankart repair for anterior shoulder instability in an adolescent population participating in collision and contact sports.Study Design:Case series; Level of evidence, 4.Methods:This retrospective review included 39 shoulders in 37 adolescent (≤19 years) athletes who underwent primary arthroscopic Bankart repair using suture anchors with at least 2-year follow-up. All patients had a history of trauma to their shoulder resulting in an anterior dislocation. Outcome measures included patient satisfaction, the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Rowe score. Recurrence of dislocation and return to sporting activity were also assessed.Results:The mean age at the time of surgery was 16.9 years (range, 15-19 years), and the mean follow-up was 6.3 years (range, 4.3-10.0 years); 58.6% of patients participated in collision sports. Time to surgery after the initial dislocation episode was 9.2 months (range, 0.5-36.2 months). Four shoulders (10.3%) had dislocation events postoperatively. The majority (78.1%) of patients returned to sports at the same level of competition. Mean VAS was 0.49 ± 1.0, and the mean ASES and Rowe scores were 92.8 ± 12.6 and 85.0 ± 24.2, respectively. Univariate analyses demonstrated that subjective functional outcomes were negatively correlated with recurrence (ASES, P = .005; Rowe, P = .001) and failure to return to sport (ASES, P = .016; Rowe, P = .004). Independent variables shown to have no significant relationship to functional outcomes included age, follow-up, number of preoperative dislocations, time to surgery, sport classification, competition level, tear extent, number of anchors, concurrent Hill-Sachs lesion, and repair of a superior labral anterior-posterior (SLAP) lesion.Conclusion:Arthroscopic Bankart repair is an effective surgical option for traumatic shoulder instability in adolescents participating in collision and contact sports. At a minimum 4-year follow-up, arthroscopic Bankart repair effectively restored stability in 90% of cases; 80% returned to their preinjury level of sport.

High Variability in Functional Outcomes and Recurrences Between Contact Sports After Arthroscopic Bankart Repair: A Comparative Study of 351 Patients With a Minimum 3-Year Follow-Up

“…This classification includes in its first category (“contact and collision sports”) sports with a significant variability in terms of the frequency and intensity of the blows and the specific demand imposed on the shoulder. 4 Although this is not the only classification of contact sports, in general most authors report the results encompassing the different types of sport under the name of “contact sports.” 5 , 6 , 7 , 8 , 9 …”

Comparison of Clinical and Functional Results After Arthroscopic Bankart Repair With The Conventional Metal Anchor and The All-Soft Suture Anchor

“…Arthroscopic bankart repair has become gold standard treatment options for patients with traumatic anterior shoulder instability (1,(3)(4)(5)7,16). Several clinical studies have concluded a low rate redislocation and good functional outcomes following arthroscopic anterior stabilization of the shoulder with suture anchors (2,7,15,16).…”

“…Traumatic anterior instability is the most common type of instability in the glenohumeral joint and the most common pathology is antero-inferior labrum lesions (1)(2)(3)(4)(5)(6)(7). Open bankart repair was considered the gold standard procedure in the treatment of traumatic anterior instability; however, arthroscopic repair methods are frequently used recently (2).…”

High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: a systematic review

“…The ability to return to athletic competition also depends on the relative risk of injury that is present within each individual sport, with collision and contact athletes historically yielding less favourable outcomes in heterogeneous patient populations. 241418192829 Only a few studies have reported the rates of return to preinjury levels of athletic competition following surgical Bankart repair in the adolescent population. 1292830–32 There is a further lack of information evaluating the risk of recurrence after open and arthroscopic shoulder stabilisation in the collision and contact adolescent athlete population.…”

“…1292830–32 There is a further lack of information evaluating the risk of recurrence after open and arthroscopic shoulder stabilisation in the collision and contact adolescent athlete population. 28 Additionally, the timetable and surgeon-specific functional criteria required prior to unrestricted return to athletic competition in this age group has been sparsely reported in the literature. 3334 This is important in order to provide general guidelines to aid in determining the appropriate timelines to allow an athlete to unrestricted activity.…”