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Risk factors for recurrence after Bankart repair a systematic review
P Randelli1, V Ragone, S Carminati
1Dipartimento di Scienze Medico-Chirurgiche, Università Degli Studi Di Milano, IRCCS, Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. pietro.randelli@unimi.it
Summary
Recurrent anterior shoulder instability after arthroscopic Bankart repair is influenced by patient age, gender, and sports participation. Factors like fewer anchors and bone loss increase recurrence risk, guiding revision surgery decisions.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Biomechanical engineering
Background:
- Arthroscopic Bankart repair is a standard procedure for anterior shoulder instability.
- Recurrence of instability remains a significant challenge, impacting patient outcomes.
- Identifying pre-operative risk factors is crucial for managing patient expectations and surgical planning.
Purpose of the Study:
- To evaluate pre-operative risk factors associated with recurrent instability after arthroscopic Bankart repair.
- To identify potential indications for revision surgery in cases of recurrent anterior shoulder instability.
Main Methods:
- Systematic review of clinical trials published within the last 10 years.
- Keywords included: arthroscopy, Bankart repair, anterior shoulder instability, recurrence, suture anchors, treatment outcome.
- Data extraction focused on recurrence rates and influencing risk factors; statistical recalculation of treatment failure risk.
Main Results:
- Recurrence rates at 10 years ranged from 3.4% to 35%.
- Risk factors for recurrence included: age < 22, male gender, multiple pre-operative dislocations, competitive sports, fewer than three anchors used, knotless anchors, significant bone loss (glenoid/humeral head), and ALPSA lesions.
- These factors significantly influenced the likelihood of treatment failure.
Conclusions:
- Understanding pre-operative risk factors enables better patient counseling and realistic expectation setting.
- Accurate analysis of failure causes is essential for guiding appropriate revision surgery strategies.