Rowe and colleagues reviewed the long‑term results of their Bankart repair for recurrent anterior shoulder dislocation, including recurrence, motion and return to sport.
Case series of 162 shoulders in 161 patients operated on at Massachusetts General Hospital from 1946 to 1976, with 145 shoulders followed 1 to 30 years.
Methods
Design
Long‑term end‑result study
Operations 1946 to 1976
Patients
161 patients with 162 shoulders
145 shoulders followed
124 re‑examined in person
21 by questionnaire
Treatment
Bankart repair by the authors' technique
Capsule reattached or reinforced at the anterior glenoid rim
Follow-up
1 to 30 years (mean 6 years)
Outcomes
Recurrent dislocation
Range of motion
Return to prior competitive sport
Examiner and patient ratings
Key Findings
Dislocation recurred in 5 of the 145 followed shoulders after repair, a rate of 3.5%.
Recurrence was 25% (2 of 8) in shoulders that regained 50% of external rotation or less, vs 2% (2 of 86) in shoulders with full motion.
Recurrence was 2% in shoulders with a glenoid rim fracture, below the overall 3.5%, and no bone graft or muscle transfer was used to reinforce the rim.
Recurrence was 5% (4 of 80) in shoulders with a moderate to severe Hill‑Sachs lesion, 4.7% for moderately severe defects and 6% for severe defects.
Examiners graded 97% of results excellent or good (74% excellent, 23% good, 3% poor), and patients rated 98% excellent or good.
Only 2 of 77 athletes did not get back to their preinjury competitive sport: 1 of 46 with a dominant‑side dislocation and 1 of 31 with a non‑dominant‑side dislocation.
Board pearl
No Bankart lesion was found in 14.2% of shoulders, and none of these recurred after capsular reinforcement at the rim (average follow‑up 7 years).
Authors' conclusion
We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.
Rowe and colleagues reviewed the long‑term results of their Bankart repair for recurrent anterior shoulder dislocation, including recurrence, motion and return to sport.
Case series of 162 shoulders in 161 patients operated on at Massachusetts General Hospital from 1946 to 1976, with 145 shoulders followed 1 to 30 years.
Methods
Design
Long‑term end‑result study
Operations 1946 to 1976
Patients
161 patients with 162 shoulders
145 shoulders followed
124 re‑examined in person
21 by questionnaire
Treatment
Bankart repair by the authors' technique
Capsule reattached or reinforced at the anterior glenoid rim
Follow-up
1 to 30 years (mean 6 years)
Outcomes
Recurrent dislocation
Range of motion
Return to prior competitive sport
Examiner and patient ratings
Key Findings
Dislocation recurred in 5 of the 145 followed shoulders after repair, a rate of 3.5%.
Recurrence was 25% (2 of 8) in shoulders that regained 50% of external rotation or less, vs 2% (2 of 86) in shoulders with full motion.
Recurrence was 2% in shoulders with a glenoid rim fracture, below the overall 3.5%, and no bone graft or muscle transfer was used to reinforce the rim.
Recurrence was 5% (4 of 80) in shoulders with a moderate to severe Hill‑Sachs lesion, 4.7% for moderately severe defects and 6% for severe defects.
Examiners graded 97% of results excellent or good (74% excellent, 23% good, 3% poor), and patients rated 98% excellent or good.
Only 2 of 77 athletes did not get back to their preinjury competitive sport: 1 of 46 with a dominant‑side dislocation and 1 of 31 with a non‑dominant‑side dislocation.
Board pearl
No Bankart lesion was found in 14.2% of shoulders, and none of these recurred after capsular reinforcement at the rim (average follow‑up 7 years).
Authors' conclusion
We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.