Arthroscopic Posterior Bankart Repair: Risk Factors for Recurrence of Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Arthroscopic posterior Bankart repair (APBR) has high failure and reoperation rates, necessitating further investigation.
• Recurrent posterior shoulder instability presents a significant challenge in athletic populations.

Purpose of the Study:

• To assess mid- to long-term outcomes of APBR for recurrent posterior shoulder instability in athletes.
• To identify predictors of failure following APBR in this patient cohort.

Main Methods:

• Retrospective case series (Level of evidence, 4) of 44 athletes undergoing APBR for posterior instability.
• Standardized surgical technique included suture anchor reattachment and capsular shift; mean follow-up was 11 years.
• Outcomes assessed included pain, apprehension, instability recurrence, range of motion, return to sport, and patient satisfaction.

Main Results:

• Recurrence of posterior instability occurred in 22% of patients, with 4% requiring reoperation.
• Posterior glenoid bone erosion was significantly associated with a higher risk of recurrent instability (P = .024).
• Posterior glenoid fractures did not increase the risk of recurrence; 75% returned to sport at 1 year.

Conclusions:

• Posterior glenoid erosion is the primary risk factor for APBR failure in recurrent posterior shoulder instability.
• Arthroscopic stabilization with suture anchors is a viable option even in the presence of posterior bony Bankart lesions.