Return to play and failure rates in a modified arthroscopic Bankart repair in collision & contact athletes
ESSKA Academy. Briggs K. 11/08/19; 285255; epESMA-64 Topic: D1 - Arthroscopic anterior repair (labrum, capsule)
Karen Briggs
Karen Briggs
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Introduction: Arthroscopic Bankart repair in the United States has become the surgical procedure of choice in anterior shoulder instability; however, high recurrence rates in collision & contact athletes still lead many to proceed with an open or other procedure. Our purpose was to compare the functional outcomes of a modified arthroscopic Bankart repair in collision, contact & non-contact athletes.
Methods: 32 collision and contact (24.1±9.1 yrs) & 28 non-contact (37.0±9.4 yrs) athletes underwent arthroscopic Bankart repair with a modified inferior capsular shift with a minimum of 3 suture anchors by a single surgeon. Inclusion criteria were complete anterior inferior labral detachment, with minimum of 2-year follow-up. Functional outcomes were measured using ASES, WOSI, MISS, Rowe & Constant scores and ROM. Independent samples t-test was used to assess differences between groups.
Results: Follow-up was 9.2±3.5 years in collision and contact & 10.2±4.7 years in non-contact athletes (p=0.147). Collision and contact athletes were significantly younger than non-contact athletes (p< 0.0001). 4.1±1.9 & 3.5±1.1 suture anchors were used in collision and contact & non-contact groups (p=0.348). There were no significant differences in functional scores (p>0.236) or ROM (p>0.078) between groups.
Overall recurrence rate was 5.7% (collision and contact 2/32; 6.3%; non-contact 2/38; 5.3%). Revisions included 1 contact athlete returning to baseball 3.5months postoperatively against the surgeon's advice, 1 contact athlete reinjured playing basketball after 7months, and 2 non-contact athletes reinjured during a sailing accident at 64months & volleyball injury at 72months. All underwent arthroscopic revision Bankart repair with an additional 3-4 plication sutures by the same surgeon & returned to pre-injury sports including baseball, hockey, basketball, golf & tennis without recurrence at 5+ years following revision surgery.
Discussion and conclusions: Modified arthroscopic Bankart repair (Nebelung technique with plication, min. 3 suture anchors) returns collision and contact & non-contact athletes to sports with excellent functional outcomes, low recurrence rates, and full ROM. While loss of ROM is a concern, particularly in overhead athletes, ROM was successfully restored in all patients.
Introduction: Arthroscopic Bankart repair in the United States has become the surgical procedure of choice in anterior shoulder instability; however, high recurrence rates in collision & contact athletes still lead many to proceed with an open or other procedure. Our purpose was to compare the functional outcomes of a modified arthroscopic Bankart repair in collision, contact & non-contact athletes.
Methods: 32 collision and contact (24.1±9.1 yrs) & 28 non-contact (37.0±9.4 yrs) athletes underwent arthroscopic Bankart repair with a modified inferior capsular shift with a minimum of 3 suture anchors by a single surgeon. Inclusion criteria were complete anterior inferior labral detachment, with minimum of 2-year follow-up. Functional outcomes were measured using ASES, WOSI, MISS, Rowe & Constant scores and ROM. Independent samples t-test was used to assess differences between groups.
Results: Follow-up was 9.2±3.5 years in collision and contact & 10.2±4.7 years in non-contact athletes (p=0.147). Collision and contact athletes were significantly younger than non-contact athletes (p< 0.0001). 4.1±1.9 & 3.5±1.1 suture anchors were used in collision and contact & non-contact groups (p=0.348). There were no significant differences in functional scores (p>0.236) or ROM (p>0.078) between groups.
Overall recurrence rate was 5.7% (collision and contact 2/32; 6.3%; non-contact 2/38; 5.3%). Revisions included 1 contact athlete returning to baseball 3.5months postoperatively against the surgeon's advice, 1 contact athlete reinjured playing basketball after 7months, and 2 non-contact athletes reinjured during a sailing accident at 64months & volleyball injury at 72months. All underwent arthroscopic revision Bankart repair with an additional 3-4 plication sutures by the same surgeon & returned to pre-injury sports including baseball, hockey, basketball, golf & tennis without recurrence at 5+ years following revision surgery.
Discussion and conclusions: Modified arthroscopic Bankart repair (Nebelung technique with plication, min. 3 suture anchors) returns collision and contact & non-contact athletes to sports with excellent functional outcomes, low recurrence rates, and full ROM. While loss of ROM is a concern, particularly in overhead athletes, ROM was successfully restored in all patients.
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