In the latest research on arthroscopic bony Bankart repair, researchers found that anterior shoulder instability led to improvements in functional outcomes, a low rate of recurrent instability, and a high rate of return to sports, but that larger studies are needed to confirm these findings.
Arthroscopic Bankart Repair Studies Suffer From Small ‘n’
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The study, “Clinical Outcomes of Arthroscopic Bony Bankart Repair for Anterior Instability of the Shoulder: A Systematic Review,” was published online in the American Journal of Sports Medicine on June 24, 2022.
“Individual studies reporting the clinical outcomes of arthroscopic bony Bankart repair for anterior shoulder instability have reported excellent results but have been limited by their small sample sizes. No systematic review of the literature has been performed examining the clinical outcomes of arthroscopic bony Bankart repair,” the researchers wrote.
They conducted a systematic review of the literature that included 21 studies with 769 patients. It included data on study characteristics and design, patient demographic characteristics, functional outcomes, recurrence rate, and return to sports.
The majority of the patients were male, with a mean age of 26.7 years. The mean follow-up was 42.7 months.
The most commonly reported functional outcome score was the Rowe score which improved on average from 41.9 preoperatively to 90.8 postoperatively. The overall recurrence rate was 11.9%. And the return to sports after arthroscopic bony Bankart repair was reported by 11 studies, with a pooled return to sports rate of 91.0%.
“Arthroscopic bony Bankart repair for anterior shoulder instability resulted in improvements in functional outcomes, a low rate of recurrent instability, and a high rate of return to sports. Although these findings are extremely promising, future prospective studies with larger sample sizes are needed to further evaluate the clinical outcomes of arthroscopic bony Bankart repair,” the researchers wrote.
Study authors include Aaron Z. Chen, M.D., Kaylre M. Greaves, M.D., Alirio J. deMeireles, M.D., Thomas A. Fortney, M.D., M.S., and David P. Trofa, M.D., all of Columbia University Irving Medical Center, New York. Bryan M. Saltzman of OrthoCarolina Sports Medicine Center in Charlotte, North Carolina also contributed to the study.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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