Arthroscopic Bankart Repair With Suture Anchors in Collision Versus Non-collision Athletes (SS-10)

Abstract

Introduction Open Bankart repair has been considered the gold standard for the treatment of anterior shoulder instability in collision athletes. However, recent improvements in arthroscopic techniques and the use of suture anchors have led to comparable recurrence rates. The purpose of this study was to evaluate the outcomes of arthroscopic shoulder stabilization with suture anchors in collision versus non-collision athletes. Methods A search in the senior author's database was performed; 125 labral repairs were identified between December 2005 and April 2008. 64 patients respected the inclusion criteria, 40 (20 collision athletes and 20 non-collision) were available to be evaluated at minimum 24 months' follow-up. All patients underwent arthroscopic Bankart repair with suture anchors. Recurrence rate was reported and functional outcomes according to ASES score, WOSI and SF-12 were evaluated. Statistical analysis was performed using chi-square and Student t test with 95% confidence interval (CI) and significance level set at p < 0.05. Results Overall recurrence rate (dislocation) was 5% (2 cases out of 40 patients); recurrence rate in collision athletes was 10% (2 cases out of 20 patients), no re-dislocations occurred in non-collision athletes. Two non-collision athletes presented with mild apprehension; 1 collision athlete and 1 non-collision complained of an episode of subjective instability, with a negative apprehension. WOSI score in collision group was 75.3% versus 72.6% in non-collision; ASES score was 90.6 in collision versus 81.2 in non-collision; SF-12 score was 108.2 in collision versus 101.1 in non-collision. Average loss in external rotation was 6.05° in non-collision versus 5.52° in collision; 95% of non-collision athletes were satisfied versus 90% of collision; 70% of non-collision athletes were able to return to sport at the same level versus 60% of collision. Nine of 9 professional athletes returned to the same activity level. Conclusion Collision athletes presented higher recurrence rate compared to non-collision athletes but there was no statistical difference. The functional outcomes according to ASES, WOSI and SF-12 were similar. Open Bankart repair has been considered the gold standard for the treatment of anterior shoulder instability in collision athletes. However, recent improvements in arthroscopic techniques and the use of suture anchors have led to comparable recurrence rates. The purpose of this study was to evaluate the outcomes of arthroscopic shoulder stabilization with suture anchors in collision versus non-collision athletes. A search in the senior author's database was performed; 125 labral repairs were identified between December 2005 and April 2008. 64 patients respected the inclusion criteria, 40 (20 collision athletes and 20 non-collision) were available to be evaluated at minimum 24 months' follow-up. All patients underwent arthroscopic Bankart repair with suture anchors. Recurrence rate was reported and functional outcomes according to ASES score, WOSI and SF-12 were evaluated. Statistical analysis was performed using chi-square and Student t test with 95% confidence interval (CI) and significance level set at p < 0.05. Overall recurrence rate (dislocation) was 5% (2 cases out of 40 patients); recurrence rate in collision athletes was 10% (2 cases out of 20 patients), no re-dislocations occurred in non-collision athletes. Two non-collision athletes presented with mild apprehension; 1 collision athlete and 1 non-collision complained of an episode of subjective instability, with a negative apprehension. WOSI score in collision group was 75.3% versus 72.6% in non-collision; ASES score was 90.6 in collision versus 81.2 in non-collision; SF-12 score was 108.2 in collision versus 101.1 in non-collision. Average loss in external rotation was 6.05° in non-collision versus 5.52° in collision; 95% of non-collision athletes were satisfied versus 90% of collision; 70% of non-collision athletes were able to return to sport at the same level versus 60% of collision. Nine of 9 professional athletes returned to the same activity level. Collision athletes presented higher recurrence rate compared to non-collision athletes but there was no statistical difference. The functional outcomes according to ASES, WOSI and SF-12 were similar.