Unbiased evaluation of the arthroscopic extra-articular technique for Bankart repair: a clinical and radiographic study with a 2- to 5-year follow-up

Abstract

This study performed an unbiased reexamination of patients who at least 2 years previously had undergone an arthroscopic extra-articular Bankart repair and prospectively evaluated the development of degenerative changes in the shoulder. Two unbiased observers who had never seen the patients before and had in no way been involved in the treatment of the patients were given unlimited access to the patients' files, surgical reports, and radiographs. Of the 80 patients 72 (90%) attended the follow-up 42.5 months (24–66) after the index procedure. Failures in terms of stability (redislocations and subluxations) were recorded in 14% of the patients. The Rowe score was 97 points (51–100); the Constant score was 94 (56–100) in injured shoulders and 97 points (80–100) in noninjured shoulders (P=0.002). A return to the preinjury level of activity was recorded in 73% of the patients. There was a significant increase in degenerative changes between the pre- and postoperative radiographic assessments (P<0.0001). At 2- to 5-year follow-up therefore the extra-articular arthroscopic Bankart repair resulted in stable and well-functioning shoulders in a high percentage of patients. However, the signs of radiographic degenerative changes increased between the preoperative assessments and the 2- to 5-year follow-up.