Abstract
Background: The Bankart repair remains a safe and effective method for repairing instability in shoulder injuries. We report the results of a large series of patients treated using this technique.
Materials and Methods: We retrospectively reviewed 136 consecutively treated patients with either anterior, antero-inferior or multidirectional shoulder instability over a 7-year period from 1999–2006 with a minimum of 2-year follow-up. All patients underwent open bankart repair through a deltopectoral approach, performed by a single surgeon. A thorough chart review was performed and patients were evaluated according to the Oxford Instability Score (OIS), the level of sport returned to, the influence of pre-operative physiotherapy and the incidence of redislocation.
Results: Of the 136 identified patients, 108 (79%) responded to the questionnaire. Of the responders, there were 95 males and 13 women. The average age was 24 years (range 14–72). Ninety-one patients had confirmed dislocations whereas 17 suffered from subluxations. The majority of patients had either anterior or antero-inferior instability, whereas four (3.7%) had multidirectional deficits. The average time to surgery from the index instability incident ranged from 3 months to 10 years. The average OIS was 23 which corresponded to a good result. There was no significance found in the OIS in relation to the age of the patient or pre-operative physiotherapy. Significant associations with a better outcome included: delay to surgery greater than 12 months; and the absence of multidirectional instability. Of those who actively participated in sport, 75% returned to the same level of non-contact sport where only 47% returned to a similar level in collision sports. Eight patients (7.4%) experienced re-dislocation post open repair and 3 (2.8%) reported feelings of subluxation.
Conclusions: Open bankart repair +/− capsulorrhaphy remains the gold standard for treatment of patients with shoulder instability. While our rate of success, in terms of re-dislocation, is equivalent to international norms, we found that a delay to surgery may be associated with a better outcome. Furthermore, the use of the Oxford Instability Score enables accurate and easy determination of the success of the operation.
Correspondence should be addressed to Mr Richard Wallace at Musgrave Park Hospital, 20 Stockman’s Lane, Belfast BT9 7JB, Northern Ireland.
