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Patients likely benefit from Bankart repair of initial shoulder dislocation
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COLORADO SPRINGS, Colo. — According to research presented here, Bankart repair following initial shoulder dislocation leads to improved patient outcomes.
“Recurrent dislocators had a two-times higher rate of postoperative instability and a four-times higher reoperation rate compared to first-time dislocators,” Tyler J. Marshall, MD, said in his presentation. “I think we should counsel our young athletic patients on the benefits of surgery after the first dislocation.”
Marshall and his colleagues used CPT codes to evaluate 121 patients with an average age of 19 years who underwent arthroscopic Bankart repair at a total of eight institutions between 2003 and 2013. Average patient follow-up was 51 months postoperatively.
Tyler J. Marshall
A retrospective chart review was conducted to determine patient demographics and quantity of reported preoperative dislocations, and to review imaging and the quantity of anchors placed. Patients were deemed recurrent dislocators if they had more than one dislocation prior to surgery, and postoperative instability was classified as a subluxation or dislocation postoperatively reported by the patient. Patients also completed a survey to identify Simple Shoulder Test (SST) score, return to sport, postoperative instability and whether any further surgical intervention was required.
Overall, 53 patients were assigned to the recurrent dislocation group and 68 patients were deemed first-time dislocators. The rate of postoperative instability was 9% in the first-time dislocator cohort and 47% in the recurrent dislocator group. Repeat operations to correct instability were necessary in 7% of the first-time dislocator group and in 32% of the recurrent dislocator cohort. Investigators found SST scores were 11.4 for the first-time dislocator group and 11 for the recurrent dislocator cohort.
“Roughly [75%] of the patients were what we deemed to be competitive athletes,” Marshall said, “and we observed bone loss in about 20% of both groups.” – by Christian Ingram
Reference:
Marshall TJ. Paper #103. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-10, 2016; Colorado Springs, Colo.
Disclosure: Marshall reports no relevant financial disclosures.