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Evidence-Based Risk Factors for Failure of Arthroscopic Labral Repair.

Alexander C Hayden1, John J Kelly2, Adam J Tagliero2

  • 1Department of Orthopedic Surgery, Mayo Clinic, 200 1st St SW, Rochester, 55905, MN, USA. Hayden.Alexander@mayo.edu.

Current Reviews in Musculoskeletal Medicine
|May 8, 2026
PubMed
Summary
This summary is machine-generated.

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Arthroscopic labral repair for shoulder instability has failure rates influenced by patient age, bone loss, and surgical technique. Identifying these risks helps tailor procedures for better outcomes and return to sport.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Arthroscopic labral repair is standard for anterior shoulder instability in young, active individuals.
  • Clinically significant failure rates limit the effectiveness of these procedures.

Purpose of the Study:

  • Synthesize evidence on patient-, lesion-, and technique-related risk factors for arthroscopic labral repair failure.
  • Link these risks to functional outcomes, return-to-sport (RTS), and patient-reported outcome measures (PROMs).
  • Guide counseling and procedure selection for anterior shoulder instability.

Main Methods:

  • Systematic review of contemporary evidence on arthroscopic labral repair.
  • Analysis of risk factors associated with repair failure.
Keywords:
Bankart repairBone augmentationGlenoid bone lossHill-SachsShoulderShoulder instability

Related Experiment Videos

  • Correlation of failure risks with functional outcomes, RTS, and PROMs.

    • Main Results:

    • Recurrent instability after arthroscopic Bankart repair occurs in 15-30% of cases long-term.
    • Key failure predictors include age <20, glenohumeral bone loss, Hill-Sachs lesions, hyperlaxity, and suboptimal surgical technique (e.g., <3 anchors).
    • Stable repairs yield good-to-excellent PROMs and high RTS rates; instability worsens satisfaction.

    Conclusions:

    • Failure in arthroscopic labral repair is multifactorial, involving patient and surgical elements.
    • Risk stratification using bone loss quantification and tools like the Instability Severity Index Score can guide treatment (e.g., bone augmentation).
    • Tailoring surgical strategy to individual risk profiles is crucial for optimizing long-term stability and PROMs.