title: Risk factors for shoulder re-dislocation after arthroscopic Bankart repair.
abstract: BACKGROUND
  Recent studies have shown effective clinical results after arthroscopic Bankart repair (ABR) but have shown several risk factors for re-dislocation after surgery. We evaluated whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to identify new risk factors.
  
  
  METHODS
  We performed ABR using bioabsorbable suture anchors in 102 consecutive shoulders (100 patients) with traumatic anterior shoulder instability. Average patient age and follow-up period was 25.7 (range, 14-40) years and 67.5 (range, 24.5-120) months, respectively. We evaluated re-dislocation after ABR using patient telephone interviews (follow-up rate, 100%) and correlated re-dislocation with several risk factors.
  
  
  RESULTS
  Re-dislocation after ABR occurred in nine shoulders (8.8%), of which seven sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 93 shoulders without re-dislocation, 8 had re-injury under the same conditions within the first year. Thus, re-injury within the first year was a risk for re-dislocation after ABR (P < 0.001, chi-squared test). Using multivariate analysis, large Hill-Sachs lesions (odds ratio, 6.77, 95% CI, 1.24-53.6) and <4 suture anchors (odds ratio, 9.86, 95% CI, 2.00-76.4) were significant risk factors for re-dislocation after ABR.
  
  
  CONCLUSIONS
  The recurrence rate after ABR is not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shibata
authors.affiliation: Department of Orthopaedic Surgery, Kurume University Medical Center, 155-1 Kokubu-machi, Kurume 839-0863, Fukuoka, Japan. gomasa@med.kurume-u.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Gotoh
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mitsui
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kai
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Nakamura
authors.forename: Tomonoshin
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okawa
authors.forename: Fujio
authors.initials: F
authors.lastname: Higuchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shirahama
authors.forename: Naoto
authors.initials: N
authors.lastname: Shiba
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D006801:Humans; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000379:methods*; D012008:Recurrence; D012307:Risk Factors; D012783:Shoulder Dislocation / Q000601:surgery*; D053441:Suture Anchors; D055815:Young Adult