Functional Results Of Arthroscopic Bankart Repair: A Prospective Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 1
Abstract
Background: Comparing with the others the shoulder joint has the widest range of motion, but also increased predisposition to dislocation (aproximately 50 percent of all dislocations) due to its biomechanics and less bony stability. Recurrent anterior shoulder instability results in a functional disability for the patient, in terms of both shoulder function and general health status. Recurrence is relevant with the patient age at which first dislocation occurred, closed reduction methods, immobilization time, severity of trauma, accompanied fracture and soft tissue damage. Nearly all traumatic anterior instabilities consists Bankart lesion. An avulsion of the labrum from the glenoid rim is known as Bankart lesion. Sometimes Hill-Sachs lesion, capsular laxity, SLAP lesion and rotator interval dilatation (enlargement) also accompany to anterior instability. However, difficulty in achieving strength and in returning to daily activities as well as a decreased range of motion following open Bankart procedures has led to the development of arthroscopic stabilization techniques. Materials and Methods: 54 patients underwent arthroscopic Bankart repair for recurrent anterior glenohumeral instability at Sri Guru Ram Das Institute of Medical Sciences and Research from 2009 to 2013. The inclusion criteria included recurrent anterior subluxation or dislocation after the initial episode of traumatic anterior shoulder dislocation and a Bankart lesion confimed by arthroscopic examination. Exclusion criteria included multidirectional instability, posterior instability, revision Bankart repairs, rotator cuff tears, accompanied glenoid or tuberculumfracture.Before surgery, patients completed a series of subjective and objective tests that served as a baseline for comparison postoperatively.Results: There were 54 patients, 11female (20.4%), 43 male (79.6%) which underwent arthroscopic Bankart repair. The mean age at the time of surgery was 28.5; range 18 to 49 years. There were no postoperative complications related to the arthroscopic procedure like infection, compartment syndrome, or nerve injury. The mean postoperative shoulder scores were significantly improved at the time of the final follow-up. The mean preoperative Rowe score was 20.1(15-25), which improved 89.1(25-100) postoperatively (p<0.05). According to Rowe score, the results were excellent (perfect) in 39 patients (72.2%), good in 9 patients (16.6%), moderate (mean) in 4 patients (7.4%) and poor in 2 (3.7%) patients. Conclusion: Our study shows arthroscopic Bankart repair is a successful procedure and is the future in the treatment for recurrent anterior glenohumeral instability. Good selection of patients is very important. Demonstrated high satisfaction results, and objective outcome analyses likewise further supported the efficacy of this procedure.
Authors and Affiliations
Rajan Sharma, Gagan Khanna, Aditya Bhardwaj
Keywords
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