The results of Bankart repair and capsular imbrication for recurrent anterior instability of the shoulder
Cem Zeki Esenyel, Oktay Adanır, Mesut Sönmez, Ayhan Nedim Kara
Bezm-i Alem Valide Sultan Vakıf Gureba Eğitim Hastanesi Ortopedi ve Travmatoloji Kliniği
Keywords: Joint instability/surgery; range of motion, articular; shoulder dislocation/etiology/surgery; shoulder joint/surgery.
Objectives: We evaluated the results of Bankart repair with capsular imbrication in patients with recurrent shoulder dislocation.
Patients and methods: The study included 23 patients (18 males, 5 females; mean age 22 years; range 17 to 57 years) with recurrent anterior instability of the shoulder. The number of dislocations from the initial injury to surgery ranged from 3 to 20. All the patients underwent Bankart repair and capsular imbrication. During surgery a mean of three suture anchors were used. At operation all the patients were found to have a Hill Sachs lesion, but not large enough for grafting. Clinical evaluations were made using the Constant scoring system and the criteria by Rowe et al. The mean follow-up was 22 months (range 8 to 40 months).
Results: Compared to the normal side, no significant differences were found in internal rotation and forward elevation. However, there was a mean difference of 12 degrees in external rotation (p<0.05). During the follow up, one patient had shoulder pain. Radiological examination showed partial penetration of one anchor into the joint. According to the criteria by Rowe et al., the results were excellent in 17 patients (74%), good in five patients (22%), and poor in one patient (4%). The mean Constant score was 94. None of the patients had recurrent dislocations. Those who were athletes returned to their original sportive activities and 95% of the patients returned to preinjury jobs.
Conclusion: Treatment of anterior instability of the shoulder with Bankart repair and capsular imbrication is worthy to be preferred because of early mobilization, a high functional achievement, and a low risk for complications.