Outcomes After Arthroscopic Bankart Repair in Adolescent Athletes Participating in Collision and Contact Sports

Abstract

To review the outcomes of arthroscopic Bankart repair for anterior shoulder instability in an adolescent population participating in collision and contact sports. A retrospective review of 39 shoulders in 37 adolescent (≤ 19 years) athletes who underwent primary arthroscopic Bankart repair using suture anchors with at least 2-year follow-up. All patients had a history of trauma to their shoulder resulting in an anterior dislocation. Outcome measures included patient satisfaction, the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES), and Rowe scores. Recurrence of dislocation, and return to sporting activity were also assessed. The average age at the time of surgery was 16.9 years (range, 15-19 years), and the average follow-up was 6.4 years (range, 4.3-10.0 years). 58.6% of patients participated in collision sports. Time to surgery after the initial dislocation episode was 9.2 months (range, 0.5-36.2 months). Four shoulders (10.3%) had dislocation events postoperatively. 78.1% of patients returned to sports at the same level of competition. Average VAS was 0.49 ± 1.01 and the average ASES and Rowe scores were 92.8 ± 12.59 and 85.0 ± 24.19, respectively. Univariate analyses demonstrated that subjective functional outcomes were negatively correlated with recurrence (ASES, P = 0.005; Rowe, P = 0.001) and failure to return to sport (ASES, P = 0.016; Rowe, P = 0.004). Independent variables shown to have no significant relationship to functional outcomes included age, follow-up, number of preoperative dislocations, time to surgery, sport classification, competition level, tear extent, number of anchors, concurrent Hill-Sachs lesions, and repair of a SLAP lesion. Arthroscopic Bankart repair is an effective surgical option for traumatic shoulder instability in adolescents participating in collision and contact sports. At a minimum of 4-year follow-up, arthroscopic Bankart repair effectively restored stability in 90% of cases; 80% returned to their preinjury level of sport.