Abstract
Although the frequency of arthroscopic revision surgery is increasing in patients with recurrent dislocation after a primary shoulder stabilization, the literature describing arthroscopic revision Bankart repair has been limited. Preferred reporting items for systematic meta-analyses guidelines were followed by utilizing PubMed, EMBASE, Scopus, and Cochrane Library databases. Keywords included shoulder dislocation, anterior shoulder instability, revision surgery, stabilization, and arthroscopic Bankart repair. Quality assessments were performed with criteria from the methodological index for nonrandomized studies (MINORS). A total of 14 articles were included in this analysis. The mean MINORS score was 12.43. A total of 339 shoulders (337 patients) were included (281 males and 56 females). The mean follow-up period was 36.7 months. Primary surgeries were as follows: arthroscopic procedures (n = 172, 50.7%), open procedure (n = 87, 25.7%), and unknown (n = 80, 23.6%). The mean rate of recurrent instability after revision arthroscopic Bankart repair was 15.3% (n = 52), and an additional re-revision procedure was needed in 6.5% of cases (n = 22). Overall, there were 18.0% (n = 61) of complications reported. This systematic review suggests that arthroscopic revision Bankart repair can lead to an improvement in functional outcomes and reasonable patient satisfaction with proper patient selection.
Highlights
The arthroscopic treatment of anterior shoulder instability has become the preferred method for primary Bankart repair with reliable outcomes [1,2,3,4,5,6]
Inclusion and exclusion criteria were met by 14 articles [16,17,18,19,20,21,22,23,24,25,26,27,28,29]
The reason for the similar results to the primary arthroscopic Bankart repair is considered to be that most of the studies included in this systematic review had strict inclusion and exclusion criteria about bone loss
Summary
The arthroscopic treatment of anterior shoulder instability has become the preferred method for primary Bankart repair with reliable outcomes [1,2,3,4,5,6]. Published studies show that arthroscopic procedures have similar outcomes and recurrence rates as open procedures [8,9,10]. Failure rates of initial arthroscopic stabilization procedures were reported to range from 5 to 15%, often needing additional revision surgery [11,12,13,14]. The treatment of recurrent instability after initial stabilization remains controversial. Failures after initial treatment have been treated by open revision Bankart repair. Surgeons have become more familiar with shoulder arthroscopy due to the evolution of surgical devices and increased educational opportunities, the use of arthroscopic revision surgery will increase in the future
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