Open and arthroscopic posterior bankart repair

Abstract

Posterior shoulder instability is commonly missed as a cause of shoulder dysfunction, due to the fact that clinical symptoms may differ from those found in anterior instability. Microtraumas produced by repetitive gestures cause progressive injury of the posterior stabilizers of the joint, causing mostly pain. It is crucial to identify the etiology and the clinical pattern to decide the correct treatment. Traumatic unidirectional instability is often related to labrum injury and capsular stretching. Additional bone loss on posterior glenoid rim or anterior humeral head can be found. In these cases, posterior labrum repair is usually performed using arthroscopic techniques. Capsular plications and treatment of the bone defects may be associated if necessary. Open surgical procedures can be used when significant posterior glenoid bone loss is present or a previous soft-tissue stabilization has failed, but there is trend on limiting the indications of open surgical approaches. Overall outcomes are very satisfactory in terms of patient’s satisfaction, recurrence rate, and return to play, though return to the pre-injury level may depend on the type of sport practiced.