Revisiting the Open Bankart Experience

BACKGROUND: The open Bankart technique for posttraumatic recurrent anterior instability has become the procedure of choice for patients who do not respond to nonoperative treatment. HYPOTHESIS: The open Bankart procedure renders stable and well-functioning shoulders in the long term in a large proportion of patients. STUDY DESIGN: Retrospective follow-up study with independent reexaminers. METHODS: Fifty-four patients (54 shoulders) with symptomatic, posttraumatic, recurrent anterior shoulder instability underwent an open Bankart reconstruction procedure with suture anchors. All of the patients had a Bankart lesion. Forty-seven patients (87%) were reexamined by independent observers at a mean follow-up period of 69 months (range, 48 to 114). RESULTS: The recurrence rate, including both dislocations and subluxations, was 17% (8 of 47). The median Rowe score was 90 points (range, 24 to 100) at the follow-up, and the median Constant score was 88.5 points (range, 41 to 100). External rotation in abduction was a median of 90 degrees (range, 25 degrees to 125 degrees ) in the involved shoulders, as compared with 97.5 degrees (80 degrees to 125 degrees ) in the noninjured shoulders (P < 0.0001). CONCLUSIONS: We conclude that, in the long term, the open Bankart procedure resulted in an unexpectedly high number of patients with failure in terms of stability. These results emphasize the importance of performing long-term follow-up studies after surgical reconstruction for unidirectional, posttraumatic, anterior shoulder instability using any type of technique.