EVALUATION OF RESULTS OF ARTHROSCOPIC BANKART REPAIR IN TRAUMATIC RECURRENT ANTERIOR SHOULDER INSTABILITY IN ADULT PATIENTS: A 10 YEAR FOLLOW-UP STUDY

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Dr. Sutanu Goswami
Dr. Shekhareswar De
Dr. Shouvik Chowdhury
Dr. Tania Mukherjee

Keywords

Shoulder Arthroscopy, Bankart Lesion, Arthroscopic Bankart Repair, Long Term Outcome.

Abstract

Background: Arthroscopic Bankart repair has become the standard of care in the surgical treatment of Bankart’s lesion of shoulder. Though long term follow-up studies on Arthroscopic Bankart repair are coming up at various parts of the world, there is still shortage of such studies in the Indian sub-continent.


Method: A total of 59 patients with post-traumatic recurrent anterior dislocation of shoulder was operated arthroscopically with suture anchors at a well reputed teaching hospital in eastern India. Of the initial cohort 30 patients could be followed up for 10 years (mean 133 months) and included in the study. The were evaluated by Rowe score, Constant-Murley shoulder outcome score and UCLA shoulder score at 6 months, 1 year, 3 years, 5 years and at the end of the follow up period.


Results: Incidence of recurrence of instability was 3%. The mean pre-operative Rowe score increased post-operatively at 6 months to 71.83 (median 75, SD=18.17) and to 80.17 (median 75, SD=11.78) at the end of follow up period (p<0.001). The final results according to Rowe score were fair in 6 (20%) patients, good in 10 (33.3%) patients and excellent in the remaining 14 (46.6%). The mean Constant-Murley score increased post-operatively at 6 months to 68.2 (median 72, SD=11.9) and to 75.83 (median 79, SD=12.12) at the end of follow-up period (p<0.001). The final results according to Constant-Murley score were poor in 7 patients (23.3%), fair in 8 patients (26.6%), good in 12 (40%) patients and excellent in the remaining 3 (10%). The mean University of California and Los Angeles score increased post-operatively at 6 months to 29.3 (median 30, SD=3.87) and to 30.27 (median 31, SD=3.67) at the end of follow-up period (p<0.001). The final results according to UCLA rating were fair/poor in 4 patients (13.3%) and good/excellent in 26 (86.6%). Patient satisfaction, quantified by the visual analogue scale, which pre-operatively had a median value of 6 increased to 8 post-operatively


Conclusion: Arthroscopic Bankart repair is a successful surgery to address recurrent anterior instability of shoulder in well indicated cases, with encouraging long term results. There is scope for more such long-term follow up studies to understand the incidence of late complications like rotator cuff degeneration and arthritis.

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