2015 ISAKOS Biennial Congress ePoster #2316

Arthroscopic Bankart Repair: Minimum 10-Year Follow-Up with Emphasis on Survivorship

Stephen C. Weber, MD, San Diego, CA UNITED STATES
Sacramento Knee and Sports Medicine, Sacramento, CA, USA

FDA Status Not Applicable

Summary: Ten year minimum follow-up of arthroscopic instability surgery shows activity modification predicts outcome

Abstract:

Glenohumeral instability repair as been a challenging procedure, with early success often confounded by longer-term follow-up disclosing increasing recurrence rates. While long-term outcomes are available for open Bankart repair (1), no data exists on the long-term outcomes of arthroscopic suture anchor repair for instability. 122 patients were followed with instability repairs performed by a single surgeon from 1995 until 2003. 84% were able to be contacted. Patients were evaluated as to UCLA, Rowe, ASES, and SST scores. Instability was divided into subjective subluxation, objective subluxation, and dislocation requiring reduction. Tiegner activity scores were calculated preoperatively and at final follow-up. Survivorship data was analyzed using standard survivorship statistics, using a 5-year endpoint with assessed outcome being progression to any instability episode. Recurrent instability overall occurred in 28% of patients, only 1/3rd occurring within the standard two-year follow-up. Survivorship analysis showed a 76% five year survivorship. Functional scores averaged in the good to excellent range at follow-up despite the high number of patients with instability. Activity modification was the major predictor of success, with a Pearson correlation coefficient=0.430, P<0.02. No other variable achieved statistical significance. 65% of patients had no further surgery despite at least one recurrent instability episode. Glenohumeral instability remains a difficult problem despite advances in surgical techniques. While standard shoulder scores remain high, two-year follow-up will only capture 1/3rd of recurrent instability, and the ultimate predictor of long-term success remains activity modification.