Bankart repair for recurrent anterior glenohumeral instability: results at twenty-nine years' follow-up

Abstract

The aim of the study was to evaluate the long-term results of the open surgical technique of Bankart repair for glenohumeral instability, a procedure that is still widely used. Thirty-nine patients were operated on at our institution by use of the Bankart technique for traumatic anterior glenohumeral instability. Thirty patients were reviewed, with a mean follow-up of 29.0 years (range, 20.3-41.0 years). After surgery, all patients recovered the pretraumatic level of sporting and professional activities. Three (ten percent) had recurrence of dislocation, one of whom underwent reoperation. Between surgery and review, 5 patients needed a total shoulder arthroplasty because of symptomatic osteoarthritis. Among the 25 remaining patients, 20 had a good subjective result, 4 had a fair result, and 1 had a poor result. The mean loss of external rotation was 24 degrees, and the mean loss of internal rotation was 19 degrees. Compared with the contralateral intact shoulder, the scores measured in the operative shoulder were significantly lower (13 points less for the Constant score, 19.8 points less for the Rowe score, and 1.4 points less for the American Shoulder and Elbow Surgeons score). As seen on the radiographs, there were some signs of osteoarthritis in 7 patients. Including the 5 patients who needed shoulder prosthetic replacement, the global rate of osteoarthritis of the study was 40%. All of the patients said that they would recommend this surgery. The Bankart technique, when used for traumatic anterior glenohumeral instability, gives reliable long-term results. However, it does not prevent the development of shoulder osteoarthritis.