Patients in Whom Arthroscopic Bankart Repair is Not Enough: Evaluation and Management of Complex Anterior Glenohumeral Instability

Abstract

Arthroscopic Bankart repair has become the most common treatment option for patients who have anterior shoulder instability. Although arthroscopic Bankart repair is generally an effective treatment method, it may be insufficient for the treatment of many patients who have anterior shoulder instability. Risk factors for failure of arthroscopic Bankart repair include younger age, level and type of sport, and shoulder specific risks, such as ligamentous laxity and the presence of bone loss. Recently, researchers have defined the limits of arthroscopic Bankart repair and more clearly defined treatment options for patients who have a high risk for failure after arthroscopic Bankart repair. Surgeons must recognize patients with anterior shoulder instability in whom a more aggressive surgical approach should be considered as well as patients who have a high risk for failure after arthroscopic Bankart repair to optimize outcomes in this patient population.