Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 12, pp 3905–3911 | Cite as

Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair

  • Miguel Angel Ruiz IbánEmail author
  • Cristina Victoria Asenjo Gismero
  • Santos Moros Marco
  • Raquel Ruiz Díaz
  • Teresa del Olmo Hernández
  • Gabriel del Monte Bello
  • Miguel García Navlet
  • Jose Luis Ávila Lafuente
  • Jorge Díaz Heredia



To evaluate the efficacy of the Instability Severity Index Score (ISIS) in predicting an increased recurrence risk after an arthroscopic Bankart repair.


Retrospective review of a cohort of patients operated in three different centres. The inclusion criteria (recurrent anterior instability [dislocation or subluxation] with or without hyperlaxity, arthroscopic Bankart repair) and the exclusion criteria (concomitant rotator cuff lesion, acute first-time dislocation, surgery after a previous anterior stabilization, surgery for an unstable shoulder without true dislocation or subluxation; multidirectional instability) were those used in the study that defined the ISIS score. The medical records and a telephone interview were used to identify the six variables that define the ISIS and identify recurrences.


One hundred and sixty-three shoulders met the inclusion and exclusion criteria. Of these, 140 subjects (22 females/118 males; mean age 35.5 ± 7.9) with 142 (89.0%) shoulders were available for follow-up after 5.3 (1.1) (range 3.1–7.4) years. There were 20 recurrences (14.1%). The mean (SD) preoperative ISIS was 1.8 (1.6) in the patients without recurrence and 1.8 (1.9) in the patients with recurrence (n.s.). In the 117 subjects with ISIS between 0 and 3 the recurrence rate was 12.8%; in the 25 with ISIS 4 to 6 the rate was 20% (n.s.).


For subjects with anterior shoulder instability in which an arthroscopic Bankart repair is being considered, the use of the ISIS, when the values obtained are ≤ 6 was not useful to predict an increased recurrence risk in the midterm in this retrospectively evaluated case series. The efficacy of the ISIS score in defining a group of subjects with a preoperative increased risk of recurrence after an arthroscopic Bankart instability repair is limited in lower risk populations (with ISIS scores ≤ 6).

Level of evidence

Retrospective case series, Level IV.


Shoulder instability Recurrence ISIS Anterior shoulder instability Remplissage Bankart repair 



No external funding was received.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest regarding the issues presented in this article.

Ethical approval

The study was approved by the local Ethics committee.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  • Miguel Angel Ruiz Ibán
    • 1
    Email author
  • Cristina Victoria Asenjo Gismero
    • 1
  • Santos Moros Marco
    • 2
  • Raquel Ruiz Díaz
    • 1
  • Teresa del Olmo Hernández
    • 2
  • Gabriel del Monte Bello
    • 3
  • Miguel García Navlet
    • 3
  • Jose Luis Ávila Lafuente
    • 2
  • Jorge Díaz Heredia
    • 1
  1. 1.Unidad de Hombro y Codo, Hospital Universitario Ramón y CajalMadridSpain
  2. 2.Unidad de Miembro SuperiorHospital MazZaragozaSpain
  3. 3.Unidad de Hombro y Codo, Hospital Asepeyo CosladaMadridSpain

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