Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 16, Issue 2, pp 188–193 | Cite as

The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients

  • Billy Kan-Yip Law
  • Patrick Shu-Hang Yung
  • Eric Po-Yan Ho
  • Joseph Jeremy Hsi-Tse Chang
  • Kai-Ming ChanEmail author
Shoulder

Abstract

This study evaluated the surgical outcomes of young active patients with arthroscopic Bankart repair within 1 month after first-time anterior shoulder dislocation. From July 2002–October 2004, patients presented with first-time traumatic anterior shoulder dislocation and treated with arthroscopic stabilization within 1 month of injury were retrospectively reviewed. Magnetic resonance imaging and computed tomography were performed before the operation in all cases. Cases with contralateral shoulder multidirectional instability or glenoid bone loss of more than 30% on preoperative computed tomography on the injury side were excluded. All patients were treated with arthroscopic Bankart repair, using metallic suture anchors or soft tissue bio-absorbable anchors by a same group of surgeons and followed the same rehabilitation protocol. Recurrence, instability signs, range of motion, WOSI score, Rowe score and complications were assessed. Thirty-eight patients were recruited: the average age was 21 (16–30). All patients had definite trauma history. Radiologically, all patients had Bankart/Hill-Sachs lesion. All the operations were done within 1 month after injury (6–25 days). The average hospital stay was 1.2 days (1–5 days). The average follow-up was 28 months (24–48 months). There were two cases of posttraumatic re-dislocation (5.2%). The average external rotation lag was 5° (0–15) in 90° shoulder abduction when compared with contralateral side. 95% of patients had excellent or good Rowe score. The average WOSI score was 83%. There was one case of transient ulnar nerve palsy and one case of superficial wound infection. This study concluded that immediate arthroscopic Bankart repair with an accelerated rehabilitation program is an effective and safe technique for treating young active patients with first-time traumatic anterior shoulder dislocation.

Keywords

Shoulder Joint instability Arthroscopy Shoulder dislocation 

References

  1. 1.
    Arciero RA, Wheeler JH, Ryan JB, McBride JT (1994) Arthroscopic bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med 22:589–594PubMedCrossRefGoogle Scholar
  2. 2.
    Bottoni CR, Wilckens JH, DeBerardino TM, D’Alleyrand JCG, Rooney RC, Harpstrite JK, Arciero RA (2002) A prospective, randomized evaluation of arthroscopic stabilization versus nonoperative treatment in patients with acute, traumatic, first-time shoulder dislocations. Am J Sports Med 30:576–580PubMedGoogle Scholar
  3. 3.
    Gartsman GM, Roddey TS, Hammerman SM (2000) Arthroscopic treatment of anterior–inferior glenohumeral instability: two to five-year follow-up. J Bone Joint Surg Am 82:991–1003PubMedGoogle Scholar
  4. 4.
    Griffith JF, Antonio GE, Tong CWC, Chan KM (2003) Anterior shoulder dislocation: quantification of glenoid bone loss with CT. Am J Roentgenol 180:1423–1430Google Scholar
  5. 5.
    Itoi E, Hatakeyama Y, Urayama M, Pradhan RL, Kido T, Sato K (1999) Position of immobilization after dislocation of the shoulder. A cadaveric study. J Bone Joint Surg Am 81:385–390PubMedCrossRefGoogle Scholar
  6. 6.
    Kim SH, Ha KI, Cho YB, Ryu BD, Oh I (2003) Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg Am 85:1511–1518PubMedCrossRefGoogle Scholar
  7. 7.
    Kim SH, Ha KI, Jung MW, Lim MS, Kim YM, Park JH (2003) Accelerated rehabilitation after arthroscopic bankart repair for selected cases: a prospective randomized clinical study. Arthroscopy 19:722–731PubMedCrossRefGoogle Scholar
  8. 8.
    Kirkley A, Griffin S, McLintock H, Ng L (1998) The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med 26:764–772PubMedGoogle Scholar
  9. 9.
    Kirkley A, Litchfield R, Thain L, Spouge A (2003) Agreement between magnetic resonance imaging and arthroscopic evaluation of the shoulder joint in primary anterior dislocation of the shoulder. Clin J Sport Med 13:148–151PubMedCrossRefGoogle Scholar
  10. 10.
    Kirkley A, Werstine R., Ratjek A, Griffin S (2005) Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation. Arthroscopy 1:55–63CrossRefGoogle Scholar
  11. 11.
    Magnusson L, Kartus J, Ejerhed L, Hultenheim I, Sernert N, Karlsson J (2002) Revisiting the open bankart experience: a four- to nine-year follow-up. Am J Sports Med 30:778–782PubMedGoogle Scholar
  12. 12.
    Rowe CR. Patel D, Southmayd WW (1978) The bankart procedure: a long-term end-result study. J Bone Joint Surg Am 60:1–16Google Scholar
  13. 13.
    Seybold D, Gekle C, Fehmer T, Pennekamp W, Muhr G, Kalicke T (2006) Immobilization in external rotation after primary shoulder dislocation. Chirurg 77:821–826PubMedCrossRefGoogle Scholar
  14. 14.
    Strahovnik A, Fokter SK (2006) Long-term results after open bankart operation for anterior shoulder instability. A 3- to 16-year follow-up. Wien Klin Wochenschr 118:58–61PubMedCrossRefGoogle Scholar
  15. 15.
    Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85:878–884PubMedGoogle Scholar
  16. 16.
    Thal R (2001) A knotless suture anchor: design, function and biomechanical testing. Am J Sports Med 29:646–649PubMedGoogle Scholar
  17. 17.
    Wheeler JH, Ryan JB, Arciero RA. Molinari RN (1989) Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy 5:213–217PubMedCrossRefGoogle Scholar
  18. 18.
    Wolf E (1989) Anterior portals in shoulder arthroscopy. Arthroscopy 5:201–208PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Billy Kan-Yip Law
    • 1
    • 2
  • Patrick Shu-Hang Yung
    • 1
    • 2
  • Eric Po-Yan Ho
    • 1
    • 2
  • Joseph Jeremy Hsi-Tse Chang
    • 1
    • 2
  • Kai-Ming Chan
    • 1
    • 2
    Email author
  1. 1.Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
  2. 2.The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, Faculty of MedicineThe Chinese University of Hong KongHong KongChina

Personalised recommendations