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.