What Are the Long-Term Outcomes of Arthroscopic Bankart Repair?
For many years open treatment was considered the procedure of choice for surgical stabilization of a patient with shoulder dislocation. With this approach, an incision is made in the front of the shoulder and then the labrum and capsule are repaired to the bone. The downside of this approach is that it is quite invasive (which raises the risk of infection) and it is difficult to address other pathology in the shoulder.With an arthroscopic approach, a camera is inserted in the shoulder and the labrum is repaired to the bone with anchors. Usually 3 to 4 stab incisions each about 1 cm in length are made and cannulas (tubes) are placed to allow access to the shoulder. The benefits of this approach are that it allows full visualization of the pathology and decreases the surgical invasiveness.Although some surgeons worried that an arthroscopic approach would not provide as good of fixation as an open approach, a recent long term study from Germany (see article) clearly demonstrates this is not true. The authors examined 180 arthroscopic repairs at a minimum of 10 years after surgery. Re-dislocation was comparable to reports from open surgery with a re-dislocation rate of 18%. Overall 92% of patients were satisfied. The authors also found that anchor type led to different rates of recurrence. Some of the older anchors (e.g. Panalok) were associated with double the rate of recurrence. If these anchors were removed the 18% would have dropped even further.This study is interesting given that anchors have continued to improve dramatically in recent years. We now are able to use anchors that are both smaller and stronger. I suspect that in future years we will see the long-term results improve further as we see this technology bear out.