Clinical Outcomes of Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability - A Systematic Review of Studies

ABSTRACT PURPOSE The purpose of this study is to review the literature to ascertain the functional outcomes, recurrences rates and subsequent revision rates following revision arthroscopic Bankart repair. METHODS Two independent reviewers performed the literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Studies where the arthroscopic Bankart repair was performed as a revision procedure were included. The clinical outcomes extracted and analyzed were functional outcomes, return to play, and recurrent instability. RESULTS Fourteen studies with 433 patients met the inclusion criteria. The majority of patients were male (63.7%) with an average age of 26.1 years (range 14-58), and mean follow-up of 37.6 months (range 10-144). The mean Rowe score was 84.2, and 79.7% patients had good-excellent outcomes. The rate of return to play was 78.5% with 47.5% returning to their pre-injury level of play across 10 studies. The rate of recurrent instability was reported in 12 studies with 328 shoulders demonstrating 86 instability events (26.2%). The rate of recurrent instability due to dislocation was reported in 7 studies (n = 176) with 19 events (10.8%) while the rate of subluxation was reported in 4 studies (n = 76) with 6 events (7.9%). CONCLUSIONS Revision arthroscopic Bankart repair for anterior shoulder instability has been shown to result in high rate of recurrent shoulder instability. There was a relatively poor rate of return to sport among athletes, and only about half of the patients were able to return at or above their preoperative ability.