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Glenohumeral osteoarthritis after arthroscopic Bankart repair for anterior instability
Francesco Franceschi1, Rocco Papalia, Angelo Del Buono
1Department of Orthopaedic and Trauma Surgery, the University Campus Bio-Medico of Rome, Rome, Italy.
Background:
Few data on shoulder arthropathy in patients undergoing arthroscopic repair for glenohumeral instability are available.
Hypothesis:
Arthroscopic stabilization of Bankart lesions does not prevent the development of postoperative glenohumeral osteoarthritis.
Study Design:
Case series; Level of evidence, 4.
Methods:
Clinical (Rowe and Constant scores) and radiographic preoperative and postoperative data from 60 patients who underwent arthroscopic Bankart repair were compared. Osteoarthritis was graded preoperatively and postoperatively with the Buscayret classification grading system. The average age at surgery was 27.6 years, and follow-up averaged 8.0 years.
Results:
The postoperative incidence of osteoarthritis in patients with no preoperative degenerative changes was 21.8% (12 of 55 patients). The incidence of degenerative joint disease of the glenohumeral joint showed evidence of a statistically significant association with older age at first dislocation and at surgery, increased length of time from the first episode to surgery, increased number of preoperative dislocations, increased length of time from the initial dislocation until surgery, increased number of anchors used at surgery, and more degenerated labrum at surgery. A higher number of preoperative dislocations, a greater length of follow-up, and reduced external rotation in abduction influenced Rowe and Constant scores.
Conclusion:
The number of anchors used and the state of the labrum are the most important factors associated with a higher risk of radiographic degenerative changes. Longer follow-up investigations are needed to draw meaningful conclusions.