Vol.:(0123456789) 1 3
Knee Surgery, Sports Traumatology, Arthroscopy
https://doi.org/10.1007/s00167-019-05534-y
SHOULDER
Ten percent re‑dislocation rate 13 years after the arthroscopic Bankart
procedure
Marianne Larsen van Gastel
1
· Nienke W. Willigenburg
1
· Lea M. Dijksman
2
· Robert Lindeboom
3
·
Michel P. J. van den Bekerom
1
· Victor P. M. van der Hulst
4
· W. Jaap Willems
1,5
· Derek F. P. van Deurzen
1
Received: 30 August 2018 / Accepted: 7 May 2019
© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract
Purpose The aim of the present study was to determine the long-term outcome after the arthroscopic Bankart procedure, in
terms of recurrent instability, shoulder function, glenohumeral arthropathy and patient satisfaction.
Methods Patients who underwent the arthroscopic Bankart procedure between January 1999 and the end of December
2005 were invited to complete a set of Patient Reported Outcome Measures (PROMs) and visit the hospital for clinical and
radiological assessment. PROMs included the Western Ontario Shoulder Instability Index (WOSI), the Oxford Shoulder
Instability Score (OSIS) and additional questions on shoulder instability and patient satisfaction. Clinical assessment included
the apprehension test and the Constant–Murley score. The Samilson–Prieto classifcation was used to assess arthropathy on
standard radiographs. The primary outcome was a re-dislocation that needed reduction. Secondary outcomes in terms of
recurrent instability included patient-reported subluxation and a positive apprehension test.
Results Of 104 consecutive patients, 71 patients with a mean follow-up of 13.1 years completed the PROMs, of which
53 patients (55 shoulders) were also available for clinical and radiological assessment. Re-dislocations had occurred in 7
shoulders (9.6%). Subluxations occurred in 23 patients (31.5%) and the apprehension test was positive in 30 (54.5%) of the
55 shoulders examined. Median functional outcomes were 236 for WOSI, 45 for OSIS, and 103 for the normalized Con-
stant–Murley score. Of all 71 patients (73 shoulders), 29 (39.7%) reported being completely satisfed, 33 (45.2%) reported
being mostly satisfed and 8 (11%) reported being somewhat satisfed. Glenohumeral arthropathy was observed in 33 (60%)
of the shoulders.
Conclusion Despite 10% re-dislocations and frequent other signs of recurrent instability, shoulder function and patient
satisfaction at 13 years after arthroscopic Bankart repair were good.
Level of evidence Level IV.
Keywords Shoulder · Recurrent instability · Arthroscopic Bankart procedure · Arthropathy
Introduction
During the frst 2 years after an anterior traumatic shoul-
der dislocation, 25–46% of the patients develop recurrent
instability with re-dislocations or persistent symptomatic
subluxations of the glenohumeral joint [1]. Although non-
operative treatment after dislocation of the shoulder can lead
to satisfactory results, it is still associated with a failure rate
of 58% 3–10 years after the initial dislocation [2].
To restore glenohumeral stability, several surgical meth-
ods can be performed, including the open or arthroscopic
Bankart procedure. The arthroscopic Bankart procedure has
gained wide popularity when treating recurrent anterior gle-
nohumeral instability [3]. Compared to the open procedure,
* Derek F. P. van Deurzen
D.F.P.vanDeurzen@olvg.nl
1
Department of Orthopedics, OLVG, Amsterdam,
The Netherlands
2
Quality and Safety Department, Unit Value-Based
Healthcare, St. Antonius Hospital, Nieuwegein,
The Netherlands
3
Department of Clinical Epidemiology, Biostatistics
and Bioinformatics, Academic Medical Center, University
of Amsterdam, Amsterdam, The Netherlands
4
Department of Radiology, OLVG, Amsterdam,
The Netherlands
5
Lairesse Kliniek, Amsterdam, The Netherlands