The open-modified Bankart procedure: long-term follow-up 'a 16-26-year follow-up study'.

INTRODUCTION

A Bankart procedure is a surgical technique for the repair of recurrent shoulder joint dislocations. This study reports the long-term results of the 'open'-modified Bankart procedure.

METHODS

We performed a retrospective cohort study in which patients are studied who had open-modified Bankart surgery for instability problems in the absence of a substantial osseous glenoid defect after a traumatic shoulder dislocation, 16-26 years ago, in a large regional hospital. Instability was measured with the Rowe and Oxford shoulder instability score. Furthermore, we measured physical functioning with the Constant-Murley score and the Dutch simple shoulder test. Pain was measured with the NRS for pain. Osteoarthritis was scored according the Samilson-Prieto score. Quality of life was measured with the SF-12 score. The operated shoulder was compared to the non-operated contralateral shoulder regarding instability and osteoarthritis.

RESULTS

39 patients were included with an average follow-up of 21 years (range 16-26 years). The number of patients with redislocations of their shoulder after surgery was 4 (10%). 23% of the study group described moments of subluxation or positive apprehension. Radiological signs of osteoarthritis were present in 20 shoulders (51%), of which 75% had grade 1 arthropathy according to the Samilson Prieto score. The incidence of osteoarthritis of the operated shoulder was significantly greater compared to the non-operated shoulder. The mean Rowe score was 85 points (25-100) and the Constant score 92 points (70-100).

CONCLUSION

We conclude that the open-modified Bankart procedure is a reliable surgical procedure with good long-term results, 16-26 years after surgery. However, it does not prevent the development of shoulder osteoarthritis, since a high number of patients had (mainly mild) radiological osteoarthritis.