Twenty years of open surgeries to repair unstable shoulders from dislocation have brought many improvements. Excellent results are reported and the recurrence rate has dropped. Now surgeons are doing some of these operations arthroscopically. In this report, results of the Bankart procedure done by arthroscope are compared to earlier results with the open technique.
The Bankart procedure is used to repair shoulder instability caused by torn ligaments and a torn labrum. The labrum is a rim of cartilage around part of the shoulder socket that helps hold the shoulder in place. If the tear extends up far enough, it will even pull some of the biceps tendon away from where it inserts into the labrum.
The Bankart repairs each of the soft tissues damaged by the dislocation. During arthroscopy, the surgeons repaired each damaged area of soft tissue. They used suture anchors to hold the biceps in place. The arthroscopic repair carefully mimicked all the steps used in the open approach.
Pain, motion, and function were used as measures of success or failure. Recurrence of shoulder dislocation was considered a failure. Patients were followed for at least two years. Pain decreased and motion and function improved for 90 percent of the patients. Ten percent had at least one or more shoulder dislocations after surgery.
The authors say the 10 percent recurrence rate is similar to the open Bankart repairs. They credit this success to using the same methods used in the open technique. Making sure that all injuries are repaired is a key factor in the success rate. Results were similar for collision athletes versus noncontact patients.