Arthroscopic Bankart Procedure: Two- to Five-Year Followup With Clinical Correlation to Severity of Glenoid Labral Lesion

We report our results using the arthroscopic Bankart technique described by Morgan (transglenoid suture) on 60 consecutive patients with anterior instability. All had detachment of the glenoid labrum at surgery. Forty-seven patients were available for final followup, which ranged from 2 to 5 years. Of these patients, 18 had experienced recurrent dislocation and 3 had experienced episodes of subluxation after surgery, for an overall failure rate of 42%. Partway into the study, we began to correlate severity of glenoid labral lesion with outcome. We classified the labral lesion in 37 patients using stringent criteria at the time of surgery. Followup among these patients averaged 37 months. Of 22 cases of simple detachment of the labrum with no other significant lesion (Type II labrum), there was one failure (4.5%). Of the 15 cases with significant or complete degeneration of the glenoid labrum-inferior glenohumeral ligament complex (Types IV or V labra), 13 failed (87%). Of the patients without recurrent instability, loss of external rotation averaged 1.5 degrees, strength was 5+/5+ in abduction and external rotation. Average postoperative function was 94% of preinjury levels subjectively, and most patients were able to return to previous activities, including throwing and other overhead sports. Our findings indicate that rates of redislocation after this arthroscopic Bankart procedure correlate directly with the degree of glenoid labrum-inferior glenohumeral ligament complex lesion.