Similar Clinical, Return to Sports, Recurrence, and Revision Outcomes Between Female and Male Athletes Following Arthroscopic Bankart Repair

Published:September 30, 2022DOI:


      To compare return to sports, functional outcomes, and recurrences rates between female and male athletes following arthroscopic Bankart repair (ABR).


      A retrospective comparative study was performed between male and female athletes who underwent an ABR between January 2008 and December 2019. Sports practiced primarily by men in our practice (including rugby, soccer, boxing, and martial arts) were excluded. Functional outcomes included the Rowe score, visual analog scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). Return to sport, recurrence, and revisions were evaluated. Additionally, we assessed the period (months) between surgery and recurrence events.


      A total of 58 female and 106 male patients were available for analysis at a median follow-up of 60 (interquartile range [IQR], 36-84) months. Ninety-one percent of the patients (n = 150) returned to sports and 84% (n = 126) returned to their preinjury level at a median of 6 months (IQR, 5-8) postoperatively. There were no differences in the rate of return to sports between females and males (91 vs 92% respectively, P = .997). There were no differences between the groups regarding postoperative functional outcomes, with most patients achieving the minimal clinically significant difference (Rowe: 98% female and 99% male, P = .584; ASOSS: 100% female and 99% male, P = .646). The overall recurrence rate was 9.7% (n = 16), with a rate of 10.3% (n = 6) in female and 9.4% (n = 10) in male athletes (P = .851). Time to event analysis showed that the median time to recurrence was 48 months in both groups (P = .848). The overall revision rate was 3% (n = 4), without significant differences between groups (P = .556).


      When compared within similar sports, there does not appear to be sex-related differences in functional outcomes, recurrence, or return to play following ABR.

      Level of Evidence

      III, retrospective comparative study.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Carter C.W.
        • Ireland M.L.
        • Johnson A.E.
        • et al.
        Sex-based differences in common sports injuries.
        J Am Acad Orthop Surg. 2018; 26: 447-454
        • Vermeulen A.E.
        • Landman E.B.M.
        • Veen E.J.D.
        • Nienhuis S.
        • Koorevaar C.T.
        Long-term clinical outcome of arthroscopic Bankart repair with suture anchors.
        J Shoulder Elbow Surg. 2019; 28: 137-143
        • Owens B.D.
        • Dawson L.
        • Burks R.
        • Cameron K.L.
        Incidence of shoulder dislocation in the United States military: Demographic considerations from a high-risk population.
        J Bone Joint Surg Am. 2009; 91: 791-796
        • Cannizzaro C.K.
        • Schuette H.B.
        • Houck D.A.
        • et al.
        Sex-based differences in recurrence rates following arthroscopic anterior shoulder stabilization: A systematic review.
        Sports Med Arthrosc Rehabil Ther Technol. 2020; 2: e637-e644
        • Magnuson J.A.
        • Wolf B.R.
        • Cronin K.J.
        • et al.
        Sex-related differences in patients undergoing surgery for shoulder instability: A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study.
        J Shoulder Elbow Surg. 2019; 28: 1013-1021
        • Frank R.M.
        • Salem H.S.
        • Richardson C.
        • et al.
        Clinical outcomes of shoulder stabilization in females with glenoid bone loss.
        Orthop J Sports Med. 2021; 923259671211007525
        • Owens B.D.
        • Agel J.
        • Mountcastle S.B.
        • Cameron K.L.
        • Nelson B.J.
        Incidence of glenohumeral instability in collegiate athletics.
        Am J Sports Med. 2009; 37: 1750-1754
        • Goodman A.D.
        • DeFroda S.F.
        • Gil J.A.
        • Kleiner J.E.
        • Li N.Y.
        • Owens B.D.
        Season-ending shoulder injuries in the National Collegiate Athletic Association: Data from the NCAA Injury Surveillance Program, 2009-2010 through 2013-2014.
        Am J Sports Med. 2018; 46: 1936-1942
        • Kraeutler M.J.
        • McCarty E.C.
        • Belk J.W.
        • et al.
        Descriptive epidemiology of the MOON shoulder instability cohort.
        Am J Sports Med. 2018; 46: 1064-1069
        • Zacchilli M.A.
        • Owens B.D.
        Epidemiology of shoulder dislocations presenting to emergency departments in the United States.
        J Bone Joint Surg Am. 2010; 92: 542-549
        • Kay M.C.
        • Register-Mihalik J.K.
        • Gray A.D.
        • Djoko A.
        • Dompier T.P.
        • Kerr Z.Y.
        The epidemiology of severe injuries sustained by National Collegiate Athletic Association student-athletes, 2009-2010 through 2014-2015.
        J Athl Train. 2017; 52: 117-128
        • Randelli P.
        • Ragone V.
        • Carminati S.
        • Cabitza P.
        Risk factors for recurrence after Bankart repair a systematic review.
        Knee Surg Sports Traumatol Arthrosc. 2012; 20: 2129-2138
        • Verweij L.P.E.
        • van Spanning S.H.
        • Grillo A.
        • et al.
        Age, participation in competitive sports, bony lesions, ALPSA lesions, > 1 preoperative dislocations, surgical delay and ISIS score > 3 are risk factors for recurrence following arthroscopic Bankart repair: A systematic review and meta-analysis of 4584 shoulders.
        Knee Surg Sports Traumatol Arthrosc. 2021; 29: 4004-4014
        • Wessel L.E.
        • Eliasberg C.D.
        • Bowen E.
        • Sutton K.M.
        Shoulder and elbow pathology in the female athlete: Sex-specific considerations.
        J Shoulder Elbow Surg. 2021; 30: 977-985
        • Moore T.K.
        • Hurley E.T.
        • Rowe D.N.
        • et al.
        Outcomes following arthroscopic Bankart repair in female patients.
        J Shoulder Elbow Surg. 2020; 29: 1332-1336
        • Rossi L.A.
        • Tanoira I.
        • Gorodischer T.
        • Pasqualini I.
        • Ranalletta M.
        High variability in functional outcomes and recurrences between contact sports after arthroscopic Bankart repair: A comparative study of 351 patients with a minimum 3-year follow-up.
        Sports Med Arthrosc Rehabil Ther Technol. 2020; 2: e575-e581
        • DeFroda S.F.
        • Donnelly J.C.
        • Mulcahey M.K.
        • Perez L.
        • Owens B.D.
        Shoulder instability in women compared with men: Epidemiology, pathophysiology, and special considerations.
        JBJS Rev. 2019; 7: e10
        • Araújo C.G.S.
        • Scharhag J.
        Athlete: A working definition for medical and health sciences research.
        Scand J Med Sci Sports. 2016; 26: 4-7
        • Chuang T.Y.
        • Adams C.R.
        • Burkhart S.S.
        Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability.
        Arthroscopy. 2008; 24: 376-382
        • Burkhart S.S.
        • De Beer J.F.
        Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.
        Arthroscopy. 2000; 16: 677-694
        • Rowe C.R.
        • Patel D.
        • Southmayd W.W.
        The Bankart procedure.
        J Bone Joint Surg. 1978; 60: 1-16
        • Stein T.
        • Linke R.D.
        • Buckup J.
        • et al.
        Shoulder sport-specific impairments after arthroscopic Bankart repair: A prospective longitudinal assessment.
        Am J Sports Med. 2011; 39: 2404-2414
        • Park I.
        • Lee J.H.
        • Hyun H.S.
        • Lee T.K.
        • Shin S.J.
        Minimal clinically important differences in Rowe and Western Ontario Shoulder Instability Index scores after arthroscopic repair of anterior shoulder instability.
        J Shoulder Elbow Surg. 2018; 27: 579-584
        • Norman G.R.
        • Sloan J.A.
        • Wyrwich K.W.
        Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation.
        Med Care. 2003; 41: 582-592
        • Committee on Sports Medicine
        Recommendations for participation in competitive sports.
        Pediatrics. 1988; 81: 737-739
        • Kennedy M.I.
        • Murphy C.
        • Dornan G.J.
        • et al.
        Variability of reporting recurrence after arthroscopic Bankart repair: A call for a standardized study design.
        Orthop J Sports Med. 2019; 72325967119846915
        • Abdul-Rassoul H.
        • Galvin J.W.
        • Curry E.J.
        • Simon J.
        • Li X.
        Return to sport after surgical treatment for anterior shoulder instability: A systematic review: Response.
        Am J Sports Med. 2019; 47: NP24-NP27
        • Memon M.
        • Kay J.
        • Cadet E.R.
        • Shahsavar S.
        • Simunovic N.
        • Ayeni O.R.
        Return to sport following arthroscopic Bankart repair: A systematic review.
        J Shoulder Elbow Surg. 2018; 27: 1342-1347
        • Lowenstein N.A.
        • Ostergaard P.J.
        • Haber D.B.
        • Garvey K.D.
        • Matzkin E.G.
        Sex differences in outcomes after arthroscopic Bankart repair.
        BMJ Open Sport Exerc Med. 2020; 6e000965
        • Patzkowski J.C.
        • Dickens J.F.
        • Cameron K.L.
        • Bokshan S.L.
        • Garcia E.J.
        • Owens B.D.
        Pathoanatomy of shoulder instability in collegiate female athletes.
        Am J Sports Med. 2019; 47: 1909-1914