Return to play following open Bankart repair in collision athletes aged 18 years or less

Abstract

Hypothesis: The purpose of this study was to evaluate clinical outcomes, return to play (RTP), and recurrence rates in patients aged 18 years or less who underwent open Bankart repair (OBR) for anterior shoulder instability.

Methods: A retrospective review of collision athletes under 18 years old who underwent OBR by 2 surgeons between the years 2010 and 2019 was carried out. An OBR using a subscapularis split was performed in all patients. Recurrent instability, rate of RTP, and time to RTP were recorded. The Shoulder Instability Return to Sport after Injury score, Subjective Shoulder Value score, and visual analog scale scores were also evaluated.

Results: The study included 34 male collision athletes with a mean age of 16.5 ± 1.3 years (range, 15-18 years). The mean follow-up for patients was 49.5 ± 30.7 months. A total of 30 patients (88.2%) returned to full sport at a mean time of 5.8 ± 2.2 months, with 27 (90%) managing to return at their preinjury level of participation. The mean Subjective Shoulder Value score for patients at the final follow-up was 86.8 ± 17.5, the mean Shoulder Instability Return to Sport after Injury score was 86.3 ± 22.6, and the mean visual analog scale score was 1.6 ± 1.8. Eight patients (23.5%) re-dislocated their shoulder, with 4 of them requiring a further surgery. Two patients (5.8%) reported having incidents of subluxation that did not require reduction.

Conclusion: This study found high rates of patient-reported satisfaction, excellent functional outcomes, and high rates of RTP in the medium term among young collision athletes aged 18 years or less who underwent OBR for anterior shoulder instability. However, there were high rates of recurrence with moderate rates of revision surgical stabilization in the medium term.

Keywords: Anterior shoulder instability; Bankart repair; athlete; collision; open; pediatric; return to play.