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Long-term outcomes after Bankart shoulder stabilization.
Joshua D Harris1, Anil K Gupta, Nathan A Mall
1Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. joshuaharrismd@gmail.com
Open or arthroscopic Bankart repair for anterior shoulder instability shows similar long-term outcomes. Both surgical techniques provide comparable rates of recurrent instability and return to sport, despite methodological limitations in existing studies.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Anterior shoulder instability is a common condition often treated with surgical repair.
- Open and arthroscopic Bankart repair techniques are prevalent surgical options.
- Long-term comparative outcomes and methodological quality of these repairs require systematic evaluation.
Purpose of the Study:
- To analyze the long-term clinical outcomes following open versus arthroscopic Bankart repair for anterior shoulder instability.
- To assess the methodological quality of studies comparing these surgical interventions.
- To provide evidence-based insights for surgical decision-making in managing shoulder instability.
Main Methods:
- Systematic review of Level I-IV evidence adhering to PRISMA guidelines.
- Inclusion of studies with a minimum of 5 years follow-up after open or arthroscopic Bankart repair.
- Evaluation of study quality using Modified Coleman Methodology Scores and Quality Appraisal Tool.
Main Results:
- Analysis of 26 studies involving 1,781 patients with recurrent anterior shoulder instability.
- No significant difference in recurrence rates between arthroscopic (11%) and open (8%) Bankart repair (P = .06).
- Similar rates of return to sport observed between arthroscopic suture anchor (87%) and open repair (89%) (P = .43).
- No significant difference in postoperative osteoarthritis incidence between arthroscopic suture anchor (26%) and open Bankart repair (33%) (P = .059).
Conclusions:
- Both arthroscopic suture anchor and open Bankart repair techniques offer comparable long-term clinical outcomes for anterior shoulder instability.
- Similar rates of recurrent instability, return to sport, and postoperative osteoarthritis incidence are observed between the two techniques.
- The majority of included studies exhibited poor methodological quality (Level III or IV evidence).