BANKART REPAIR FOR ANTERIOR INSTABILITY OF THE SHOULDER - LONG-TERM OUTCOMES

Anterior instability of the shoulder is a commonly encountered entity in orthopaedic practice, The Bankart procedure is considered by many s urgeons to be the treatment of choice for this condition, Despite its widespread popularity, there have been no studies on the long-term out come of the Bankart procedure as far as we know, Sixty shoulders (fift y-six patients) that had been followed for a minimum of eight years af ter a Bankart procedure were evaluated for range of motion, stability and strength according to the data form of the American Shoulder and E lbow Surgeons for examination of the shoulder, The results for the inv olved shoulder were compared with the findings for the contralateral, normal shoulder, All patients completed a questionnaire regarding the history of the instability of the shoulder, the level of participation in sports before and after the operation, the preoperative and postop erative level of pain, and whether the patient had ever sustained a di slocation that needed reduction by a physician, Information about the current ability of the patient to function at home, at work, and durin g sports also was requested, In addition, the patients were asked to r ate the results of the operation and to indicate whether they would ha ve the same procedure again for the same problem, At a mean of 11.9 ye ars after the operation, the mean loss of external rotation was 12 deg rees (range, 0 to 30 degrees) (p < 0.0001), There were no significant differences in forward elevation, abduction, or internal rotation betw een the involved shoulder and the contralateral, normal shoulder. One patient had crepitus on glenohumeral motion, Fifty-five of the fifty-s ix patients returned to the occupation that they had had preoperativel y, without having to alter their activities, Twenty-eight patients had mild pain with strenuous activity and one patient had pain at rest, T hree patients had a dislocation of the involved shoulder because of a new traumatic event more than three years postoperatively Fifty-two pa tients rated the result as good or excellent; three, as fair; and one, as poor, Fifty-four patients said that they would have a Bankart proc edure performed again for the same problem, We present a new system fo r rating the shoulder that emphasizes function and is based specifical ly on the goals stated by the patients to be most important with regar d to the shoulder, Using this system, we found that the Bankart proced ure offers an excellent objective long-term outcome with a high degree of patient satisfaction.