Revision of failed arthroscopic bankart repairs.
BACKGROUND
The results following open revision surgery following a failed arthroscopic Bankart procedure are not well documented.


OBJECTIVE
To evaluate the results of patients with a failed arthroscopic Bankart repair treated with a traditional, open Bankart repair.


METHODS
Case series; Level of evidence, 4.


METHODS
Thirty patients (28 male and 2 female) who had a mean age of 24 years (range 15-36) at the time of operation were evaluated. The mean interval from the time of the operation to the final follow-up was 46 months (range 24-55). The rating systems of Rowe and the University of California at Los Angeles (UCLA) were recorded preoperatively and at the time of the final evaluation.


RESULTS
After open repair, mean modified Rowe scores improved from 25 preoperatively to 84.2 points. The results were excellent in 2 (6.7%), good in 24 (80%), and fair in 4 (13.3%); there were no poor results. The UCLA shoulder score improved from a mean of 17 points preoperatively to 29 points (P = .001 for all comparisons). Twenty-six patients (87%) did not have an anchor placement inferior to the 4-o'clock position for a right shoulder or the 8-o'clock position for the left shoulder after the index arthroscopic repair. There were no rotator interval closures performed at the index arthroscopic Bankart repair, and 10 patients (33%) required an interval closure at the open revision procedure. Twenty-five patients (83%) immobilized the operated arm in a sling for less than 2 weeks following the index arthroscopic repair.


CONCLUSIONS
Patients with failed arthroscopic Bankart repairs can be successfully treated with a revision, open Bankart repair. Inadequate postoperative immobilization, large rotator intervals, and improper anchor placement are possible risk factors that may increase the incidence of failure of an arthroscopic Bankart repair.
Sisto
Domenick J
DJ
Los Angeles Orthopaedic Institute, Sherman Oaks, California, USA. laortho@aol.com
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012307:Risk Factors; D055502:Secondary Prevention; D012782:Shoulder / Q000601:surgery*; D000070599:Shoulder Injuries; D020069:Shoulder Pain / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome