Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 5, pp 597–603 | Cite as

The open-modified Bankart procedure: long-term follow-up ‘a 16–26-year follow-up study’

  • Thomas Berendes
  • Nina Mathijssen
  • Hennie Verburg
  • Gerald Kraan
Orthopaedic Surgery



A Bankart procedure is a surgical technique for the repair of recurrent shoulder joint dislocations. This study reports the long-term results of the ‘open’-modified Bankart procedure.


We performed a retrospective cohort study in which patients are studied who had open-modified Bankart surgery for instability problems in the absence of a substantial osseous glenoid defect after a traumatic shoulder dislocation, 16–26 years ago, in a large regional hospital. Instability was measured with the Rowe and Oxford shoulder instability score. Furthermore, we measured physical functioning with the Constant–Murley score and the Dutch simple shoulder test. Pain was measured with the NRS for pain. Osteoarthritis was scored according the Samilson–Prieto score. Quality of life was measured with the SF-12 score. The operated shoulder was compared to the non-operated contralateral shoulder regarding instability and osteoarthritis.


39 patients were included with an average follow-up of 21 years (range 16–26 years). The number of patients with redislocations of their shoulder after surgery was 4 (10%). 23% of the study group described moments of subluxation or positive apprehension. Radiological signs of osteoarthritis were present in 20 shoulders (51%), of which 75% had grade 1 arthropathy according to the Samilson Prieto score. The incidence of osteoarthritis of the operated shoulder was significantly greater compared to the non-operated shoulder. The mean Rowe score was 85 points (25–100) and the Constant score 92 points (70–100).


We conclude that the open-modified Bankart procedure is a reliable surgical procedure with good long-term results, 16–26 years after surgery. However, it does not prevent the development of shoulder osteoarthritis, since a high number of patients had (mainly mild) radiological osteoarthritis.


Shoulder Joint instability Surgery Osteoarthritis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Moseley HF (1962) Recurrent dislocation of the shoulder. Postgrad Med 31:23–29. Accessed 27 Nov 2016
  2. 2.
    Rowe CR (1956) Prognosis in dislocations of the shoulder. J Bone Jt Surg Am 38-A(5):957–977CrossRefGoogle Scholar
  3. 3.
    McLaughlin HL, MacLellan DI (1967) Recurrent anterior dislocation of the shoulder. II. A comparative study. J Trauma 7(2):191–201CrossRefPubMedGoogle Scholar
  4. 4.
    Simonet WT, Cofield RH (2010) Prognosis in anterior shoulder dislocation. Am J Sports Med 12(1):19–24. Accessed 19 Sep 2010
  5. 5.
    Rowe CR, Sakellarides HT (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48. Accessed 27 Nov 2016
  6. 6.
    McLaughlin HL, Cavallaro WU (2016) Primary anterior dislocation of the shoulder. Am J Surg 80(6):615 – 21. Accessed 27 Nov 2016 (passim)
  7. 7.
    Hovelius L (1987) Anterior dislocation of the shoulder in teen-agers and young adults. Five-year prognosis. J Bone Jt Surg Am 69(3):393–399CrossRefGoogle Scholar
  8. 8.
    Kiviluoto O, Pasila M, Jaroma H, Sundholm A (1980) Immobilization after primary dislocation of the shoulder. Acta Orthop Scand 51(6):915–919. Accessed 3 Jan 2014
  9. 9.
    Arciero RA, Wheeler JH, Ryan JB, McBride JT (1994) Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sport Med 22(5):589–594CrossRefGoogle Scholar
  10. 10.
    Henry JH, Genung JA (2010) Natural history of glenohumeral dislocation—revisited. Am J Sports Med 10(3):135–137. Accessed 19 Sep 2010
  11. 11.
    Hovelius L, Augustini BG, Fredin H, Johansson O, Norlin R, Thorling J (1996) Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study. J Bone Jt Surg Am 78(11):1677–1684CrossRefGoogle Scholar
  12. 12.
    Wheeler JH, Ryan JB, Arciero RA, Molinari RN (1989) Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy 5(3):213–217CrossRefPubMedGoogle Scholar
  13. 13.
    Rowe CR, Sakellarides HT (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48PubMedGoogle Scholar
  14. 14.
    Rowe CR (1978) Instabilities of the glenohumeral joint. Bull Hosp Jt Dis 39(2):180–186. Accessed 27 Nov 2016
  15. 15.
    Townley CO (1950) The capsular mechanism in recurrent dislocation of the shoulder. J Bone Jt Surg Am 32A(2):370–380. Accessed 27 Nov 2016
  16. 16.
    Moseley HF (1963) The basic lesions of recurrent anterior dislocation. Surg Clin N Am 43:1631–1634. Accessed 27 Nov 2016
  17. 17.
    Adams JC (1948) Recurrent dislocation of the shoulder. J Bone Jt Surg Br 30B(1):26–38. Accessed 27 Nov 2016
  18. 18.
    Handoll HHG, Almaiyah MA, Rangan A (2004) Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev 2004(1):CD004325. Google Scholar
  19. 19.
    Berendes TD, Pilot P, Nagels J, Vochteloo AJH, Nelissen RGHH (2015) Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals. Arch Orthop Trauma Surg. PubMedPubMedCentralGoogle Scholar
  20. 20.
    Berendes TD, Wolterbeek R, Pilot P, Verburg H, te Slaa RL (2007) The open modified Bankart procedure: outcome at follow-up of 10 to 15 years. J Bone Jt Surg Br 89(8):1064–1068. CrossRefGoogle Scholar
  21. 21.
    Chapnikoff D, Besson A, Chantelot C, Fontaine C, Migaud H, Duquennoy A (2000) Bankart procedure: clinical and radiological long-term outcome. Rev Chir Orthop Repar Appar Mot 86(6):558–565Google Scholar
  22. 22.
    Gill TJ, Micheli LJ, Gebhard F, Binder C (1997) Bankart repair for anterior instability of the shoulder. Long-term outcome. J Bone Jt Surg Am 79(6):850–857CrossRefGoogle Scholar
  23. 23.
    Pelet S, Jolles BM, Farron A (2006) Bankart repair for recurrent anterior glenohumeral instability: results at twenty-nine years’ follow-up. J Shoulder Elb Surg 15(2):203–207CrossRefGoogle Scholar
  24. 24.
    Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Jt Surg Am 60(1):1–16CrossRefGoogle Scholar
  25. 25.
    Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (2016) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 27(2):214–221. Accessed 29 Apr 2016
  26. 26.
    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164. Accessed 3 Feb 2016
  27. 27.
    Dawson J, Hill G, Fitzpatrick R, Carr A (2001) The benefits of using patient-based methods of assessment. Medium-term results of an observational study of shoulder surgery. J Bone Jt Surg Br 83(6):877–882CrossRefGoogle Scholar
  28. 28.
    Dawson J, Fitzpatrick R, Carr A (1999) The assessment of shoulder instability. The development and validation of a questionnaire. J Bone Jt Surg Br 81(3):420–426CrossRefGoogle Scholar
  29. 29.
    van der Linde JA, van Kampen DA, van Beers LWAH., van Deurzen DFP, Terwee CB, Willems WJ (2015) The Oxford Shoulder Instability Score; validation in Dutch and first-time assessment of its smallest detectable change. J Orthop Surg Res 10:146. CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164Google Scholar
  31. 31.
    Ware J, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233. Accessed 21 July 2016
  32. 32.
    Samilson RL, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Jt Surg Am 65(4):456–460CrossRefGoogle Scholar
  33. 33.
    Fabre T, Abi-Chahla ML, Billaud A, Geneste M, Durandeau A (2010) Long-term results with Bankart procedure: a 26-year follow-up study of 50 cases. J Shoulder Elb Surg 19(2):318–323. CrossRefGoogle Scholar
  34. 34.
    Schrumpf MA, Maak TG, Delos D et al (2014) The management of anterior glenohumeral instability with and without bone loss: AAOS exhibit selection. J Bone Joint Surg Am 96(2):e12. CrossRefPubMedGoogle Scholar
  35. 35.
    Zimmermann SM, Scheyerer MJ, Farshad M, Catanzaro S, Rahm S, Gerber C (2016) Long-term restoration of anterior shoulder stability: a retrospective analysis of arthroscopic Bankart repair versus open Latarjet procedure. J Bone Jt Surg Am 98(23):1954–1961. CrossRefGoogle Scholar
  36. 36.
    van der Linde JA, van Kampen DA, Willems JW (2013) How should we define failure after surgical shoulder stabilization? Arthroscopy 29(10):1602. CrossRefPubMedGoogle Scholar
  37. 37.
    Rosenberg BN, Richmond JC, Levine WN (1995) Long-term followup of Bankart reconstruction. Incidence of late degenerative glenohumeral arthrosis. Am J Sport Med 23(5):538–544CrossRefGoogle Scholar
  38. 38.
    Cameron ML, Kocher MS, Briggs KK, Horan MP, Hawkins RJ (2003) The prevalence of glenohumeral osteoarthrosis in unstable shoulders. Am J Sport Med 31(1):53–55CrossRefGoogle Scholar
  39. 39.
    Hawkins RJ, Angelo RL (1990) Glenohumeral osteoarthrosis. A late complication of the Putti-Platt repair. J Bone Jt Surg Am 72(8):1193–1197CrossRefGoogle Scholar
  40. 40.
    Morrey BF, Janes JM (1976) Recurrent anterior dislocation of the shoulder. Long-term follow-up of the Putti-Platt and Bankart procedures. J Bone Jt Surg Am 58(2):252–256CrossRefGoogle Scholar
  41. 41.
    O’Driscoll SW, Evans DC (1993) Long-term results of staple capsulorrhaphy for anterior instability of the shoulder. J Bone Jt Surg Am 75(2):249–258CrossRefGoogle Scholar
  42. 42.
    Trevlyn DW (1992) Degenerative joint disease following extracapsular anterior shoulder reconstruction. Contemp Orthop 25:151–156Google Scholar
  43. 43.
    Zuckerman JD, Matsen 3rd FA (1984) Complications about the glenohumeral joint related to the use of screws and staples. J Bone Jt Surg Am 66(2):175–180CrossRefGoogle Scholar
  44. 44.
    Saxena V, D’Aquilla K, Marcoon S et al (2016) T1ρ magnetic resonance imaging to assess cartilage damage after primary shoulder dislocation. Am J Sports Med. PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery and TraumatologyMeander Medisch CentrumAmersfoortThe Netherlands
  2. 2.Reinier de Graaf GasthuisDelftThe Netherlands
  3. 3.Department of Orthopaedic Surgery and TraumatologyReinier de Graaf GasthuisDelftThe Netherlands

Personalised recommendations