Hyperlaxity may increase failure rate after arthroscopic Bankart repair
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Key takeaways:
- Patients with hyperlaxity and near-track lesions had the highest risk for failure after arthroscopic Bankart repair.
- Patients with near-track lesions and hyperlaxity status had a 34-fold higher risk for failure.
NEW ORLEANS — Patients with shoulder hyperlaxity may have an increased likelihood of failure after arthroscopic Bankart repair, which may be amplified in patients with shorter distance to dislocation, according to results presented here.
“Future research should investigate the potential benefits of incorporating a remplissage procedure to alleviate the effects of hyperlaxity in patients with and without near-track lesions,” Shaquille J-C Charles, MSc, said in his presentation at the Arthroscopy Association of North America Annual Meeting. “Furthermore, exploring the utility of dynamic glenoid track measures and identifying and guiding suitable surgical interventions for patients at higher risk may be crucial.”
Charles and colleagues retrospectively reviewed data of 173 patients with anterior shoulder instability who underwent arthroscopic Bankart repair alone between 2007 and 2019. Researchers measured bone loss and calculated distance to dislocation.
“Hyperlaxity was defined as external rotation greater than 85° or greater than or equal to grade II load and shift in two or more planes,” Charles said.
He added, “Near-track lesions were defined as on-track lesions with a [distance to dislocation] DTD less than 10 mm.”
Charles noted 23.1% of patients had a recurrent subjective instability and around 16% of patients underwent a subsequent revision stabilization procedure. Independent predictors of recurrent instability included younger age, smaller DTD, hyperlaxity and greater than one instability episode preoperatively, according to results of a multivariate analysis. Charles said patients with hyperlaxity and near-track lesions had the highest risk for failure when stratified by near-track status, laxity status and glenoid bone loss.
“With a 34-fold higher risk of failure and 60% failure rate, near-track and hyperlaxity status demonstrated strong predictive value for failure with an impressive area under the curve of 0.91,” Charles said.
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Charles SJC, et al. Capsuloligamentous laxity predicts failure following arthroscopic anterior Bankart repair. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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