title: Open Bankart repair for revision of failed prior stabilization: outcome analysis at a mean of more than 10 years.
abstract: BACKGROUND
  The purpose of this study was to analyze the outcome of open Bankart repair for failed stabilization surgery at a mean follow-up of >10 years.
  
  
  METHODS
  Thirty patients underwent revision open Bankart repair by a single surgeon for failed prior stabilization surgery, with a standard technique and postoperative rehabilitation. All patients were referred by other surgeons. Evaluation was by an independent examiner, at a mean follow-up of 10.2 years. Evaluation included a history, physical examination for range of motion, outcome scores, recurrence, return to athletics, and radiographic examination.
  
  
  RESULTS
  All cases had persistent Bankart and Hill-Sachs lesions. Failures included 14 patients with a failed single arthroscopic Bankart repair; 1 patient with 2 failed arthroscopic Bankart repairs; 1 patient with an arthroscopic failure and an open Bankart repair; 7 patients with failed open Bankart repairs; and 1 patient with a failed open Bankart repair, then a failed arthroscopic attempt. Two patients had had thermal capsulorrhaphy; 2 others had staple capsulorrhaphy, 1 with an open capsular shift and 1 after a failed arthroscopic Bankart repair, an open Bankart repair, and then a coracoid transfer. All arthroscopic Bankart repairs had anchors placed medial and superior on the glenoid neck. Mean motion loss compared with the normal contralateral side was as follows: elevation 1.15°, abduction 4.2°, external rotation at the side 3.2°, external rotation in abduction 5.1°, and internal rotation 0.6 vertebral levels (NS). No patient had an apprehension sign, pain, or instability. Of 23 who played sports, 22 resumed after. Outcomes scores were as follows: American Shoulder and Elbow Surgeons, 89.44; Rowe, 86.67; Western Ontario Shoulder Instability Index, 476.26. On radiographic examination, there were 13 normal radiographs and 7 with mild, 2 with moderate, and 0 with severe arthritic changes.
  
  
  CONCLUSIONS
  The open Bankart repair offers a reliable, consistently successful option for revision of failed stabilizations.
authors.affiliation: Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Neviaser
authors.affiliation: Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Benke
authors.affiliation: Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, USA. Electronic address: rneviaser@mfa.gwu.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Neviaser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012086:Reoperation; D000068958:Return to Sport; D012399:Rotation; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bankart; Shoulder; dislocation; instability; revision; traumatic