Revision Arthroscopic Bankart Repair Results in High Failure Rates and a Low Return to Duty Rate Without Recurrent Instability

• Published in: Arthroscopy Vol. 39; no. 4; pp. 913 - 918
• Main Authors: Slaven, Sean E., Donohue, Michael A., Tardif, Robert A., Foley, Kevin A., LeClere, Lance E., Cameron, Kenneth L., Giuliani, Jeffrey R., Posner, Matthew A., Dickens, Jonathan F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2023
• Subjects: Arthroplasty - methods; Arthroscopy - methods; Humans; Joint Instability - surgery; Orthopedics; Ortopedi; Recurrence; Scapula - surgery; Shoulder Dislocation - surgery; Shoulder Joint - surgery
• ISSN: 0749-8063; 1526-3231; 1526-3231
• DOI: 10.1016/j.arthro.2022.08.044

The purpose of this study was to determine, in a military population without critical bone loss, the rate of recurrent instability after revision arthroscopic stabilization for failed primary arthroscopic Bankart repair. Forty-one revision arthroscopic stabilizations were performed at a single military institution between 2005 to 2016 for recurrent anterior shoulder instability after primary arthroscopic Bankart repair. Minimum follow-up was 2 years, and shoulders with glenoid bone loss >20% were excluded. The primary outcome of interest was the incidence of failure, defined by recurrent instability. Age at revision surgery averaged 22.9 ± 4.3 years, and 88% were either service academy cadets or active duty combat arms soldiers. Mean follow-up was 7.8 years. Twenty-three patients (56%) returned to duty without recurrent instability after revision arthroscopic stabilization. Eighteen patients (44%) experienced recurrent instability after return to duty. Glenoid bone loss averaged 6.2% (95% confidence interval [CI], 3.2%-9.2%) in the successful group and 5.7% (95% CI, 3.1%-8.3%) in the failure group (P = .808). Revision arthroscopic stabilization of failed primary arthroscopic Bankart repair has a failure rate of 44% in a young military population. The similar amounts of bone loss between groups indicates that bone loss is not the primary determinant of failure in revision arthroscopic stabilization. IV, Case Series