Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications

Morgan recently reported excellent results by arthroscopically suturing detached labra to the glenoid via drill holes in anterior shoulder dislocators. We attempted to quantitatively compare the operative time, and perioperative morbidity employing this technique to these same parameters using the open Bankart procedure. We retrospectively reviewed the records of consecutive patients undergoing either of these procedures at our institution over the past 2 years. Only those cases wherein the labra were reattached to the glenoid via drill holes were considered. There were 20 patients in the arthroscopic and 18 in the open Bankart groups. Using the arthroscopic method, there was a 1.8-fold decrease in operative time, a 10-fold decrease in blood loss, and a 2.5-fold decrease in postoperative narcotic use compared with the open procedure (p < 0.001). Postoperative fevers were similarly reduced. Hospital stay averaged 3.1 days with the open procedure compared with 1.1 days with the arthroscopic method (p < 0.001). Most arthroscopic Bankarts are now performed on a same-day basis. Time lost from work was 25.5 and 15.3 days for the open and arthroscopic procedures, respectively (p < 0.001). There were three complications among the patients treated with the open technique compared with none in the arthroscopic group. Thus, we conclude that the arthroscopic Bankart procedure offers significant improvements in operative time, perioperative morbidity, and complications compared with the open technique for patients with anterior shoulder instability.