Purpose
The purpose of this study was to investigate the functional outcomes of arthroscopic
Bankart repair for recurrent shoulder instability in the setting of moderate glenoid
bone defect ranging from 20% to 30% in patients with moderate to low functional demand.
Methods
This study included 36 patients with unilateral recurrent instability and glenoid
bone defects of 20% to 30% treated with arthroscopic stabilization. Glenoid bone loss
was estimated on the en-face view of preoperative 3-dimensional computed tomography.
Joint laxity was assessed clinically by use of the Beighton and Horan criteria, and
patients were divided into 2 groups based on the presence of excessive joint laxity,
group L (n = 13), or absence of excessive joint laxity, group N (n = 23). Functional
assessments were performed with the patient-reported activity level; subjective shoulder
value; Rowe score; and University of California, Los Angeles shoulder score.
Results
The mean glenoid defect size was 25.1% (range, 20% to 29%), and the overall functional
outcomes improved significantly after surgery. A return to greater than 90% of the
premorbid activity level was reported by 72% of patients (26 of 36 patients), and
patient satisfaction was 83% (30 of 36 patients). There was no significant difference
in functional outcomes between groups L and N (subjective shoulder value, 85.0% for
group L v 88.9% for group N, P = .397; Rowe score, 83.5 for group L v 92.8 for group N, P = .537; and University of California, Los Angeles shoulder score, 32.2 for group
L v 31.9 for group N, P = .697). Recurrent instability occurred in 4 patients (11%), 3 patients in group
L (3 of 13, 23%) and 1 patient in group N (1 of 23, 4%), but this difference was not
statistically significant (P = .125).
Conclusions
Arthroscopic stabilization for recurrent shoulder instability in patients with moderate
to low functional demand produced satisfactory outcomes despite the presence of moderate
glenoid bone defects of 20% to 30%. For patients with excessive joint laxity, however,
arthroscopic stabilization may not be reliable, with a recurrence rate of 23%.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: May 22, 2014
Accepted:
March 21,
2014
Received:
July 19,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
