Bankart procedure: clinical and radiological long-term outcome

Purpose of the study There are few reports on long-term outcome after Bankart procedure. The pur pose of this study was to determine the rate of recurrent dislocation, the clinical results and the incidence of glenohumeral osteoarthritis after a m inimum 10-year follow-up. Material and methods Ninety-seven Bankart procedures were performed in 97 patients between 1972 and 1986 for treatment of anterior shoulder instability with recurrent disl ocations. We retrospectively reviewed 74 patients and obtained 64 complete radioclinical evaluations for an average follow-up of 16 years. Clinical ev aluation was based on the G. Walch and the Duplay group score but for easie r comparisons, we also calculated the Rowe et al, score. Radiographical eva luation was established on the Samilson and Prieto classification but real glenohumeral osteoarthritis with joint narrowing was noted independently as grade four. We also studied the contralateral shoulder. Results At last follow-up, 7 shoulders (9.5%) had recurrent dislocation, but two of them occurred subsequent to severe trauma over 18 months. Most patients (9 5%) were satisfied or very satisfied. Six patients (8.1%) had persistent ap prehension but in some it was not due to anterior apprehension. According t o the Duplay score (or the Rowe score), 25 shoulders (44.6%) had an excelle nt result (35/61.4%) 16 (28.6%) a good result (7/12.3%), 11 (19.7%) a fair result (11.19.3) and 4 (5.4%) a poor result (417%). Operated shoulders were pain free for 75% and painful for forced movements only for 25%. External rotation at 90 degrees of abduction was reduced by 8.7 +/- 15.7 degrees. Th ere was no limitation of internal rotation. Patients returned to preoperati ve sports activities at the same level for 70.9% and at a lower level for 1 2.7%. According to the Samilson classification, 7 (13%) of the shoulders ha d grade 2 and 2 (3.7%) had grade 3 glenohumeral osteoarthritis. We found 4 cases (7.4%) of real glenohumeral osteoarthritis (grade four) and 2 of thes e patients had contralateral osteoarthritis of a non unstable shoulder. The re was no perioperative complication. Discussion In our hands the Bankart procedure is appeared as a safe procedure with a l ow rate of glenohumeral osteoarthritis and a high rate of patient satisfact ion.