Revision of Failed Artroscopic Bankart Repairs

Abstract

Objectives: To present our functional outcomes from patients treated arthroscopically for a failed Bankart repair,using suture anchors and capsulolabral tissue only. Method(s): Series of 22 patients presented with a recurrence of instability after a previous stabilization surgery (3Latarjet, Bankart 19). We treated them by a an all-arthroscopic procedure, avoiding bone grafts, when glenoid trackwas found to be enough to proceed. The failure was associated with trauma in 11 patients, a non-anatomic repair in6 patients, capsular laxity in 4 patients and a non-union of the coracoid graft in 1 patient.Revision surgery included: Bankart repair with anchors in 17 cases, a posterior-inferior capsulo-labral plication inone case, and 5 remplissages. In 4 cases subscapularis augmentation was used because of poor capsular quality.Screw removal was necessary when treating the non-union case.Patients were followed-up by a minimum of 23 months (range 23-26), and evaluated by the UCLA Test, SS test andRowe score. Result(s): Thirteen patients had an excellent result, 6 good, 2 satisfactory and one bad result, according to UCLAscore. The mean Rowe score was 90.4, at final follow up. The Simple Shoulder Test went from an 8 preoperative toan 11 postoperative, mean scores. 19 of 22 patients returned to the same level of activity prior to the injury.Complications: recurrence in 2 cases, subluxation in 2 and one shoulder stiffness that required an arthrolysis. Conclusion(s): An arthroscopic revision surgery, after a failed Bankart repair, presents satisfactory results in selectedpatients. Arthroscopic vision allows a correct diagnosis of injuries as possible causes of failure and subsequenttreatment.