Bankart repair with subscapularis augmentation: A case control study.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Anterior shoulder instability often involves glenoid defects and labral failure.
• Traditional Bankart repair may not fully address associated subscapularis tendon issues.
• Arthroscopic techniques offer less invasive solutions for complex shoulder instability.

Purpose of the Study:

• To evaluate the functional outcomes of Bankart repair combined with arthroscopic subscapularis tendon augmentation.
• To assess the efficacy of this combined technique in patients with anterior shoulder instability and less than 25% glenoid defects.
• To determine the impact on range of motion and patient-reported outcome scores.

Main Methods:

• Eighty-three patients with anterior shoulder instability underwent arthroscopic Bankart repair and subscapularis tendon augmentation.
• Preoperative and postoperative range of motion (goniometer) and functional scores (Constant Murley, ASES, Rowe, UCLA) were recorded.
• Statistical analysis was performed to compare pre- and postoperative measurements.

Main Results:

• Significant postoperative improvements were observed in all functional scores: Constant Murley (+41.4), ASES (+41.4), UCLA (+13.8), and Rowe (+49.3) (P < .01).
• A significant decrease in external rotation (-10.2 units) was noted postoperatively (P < .01).
• Fewer dislocations correlated negatively with internal rotation (r = -0.305) and external rotation (r = -0.329) (P < .01).

Conclusions:

• Arthroscopic Bankart repair with subscapularis tendon augmentation is an effective treatment for anterior shoulder instability with <25% glenoid defects.
• The technique demonstrates reliability and sufficiency by addressing both the labrum and subscapularis tendon as a single unit.
• While external rotation may decrease, overall functional outcomes and stability are significantly enhanced.