Summary

Kinesiophobia (fear of movement) is a major limiting factor in the return to pre-injury sport level after arthroscopic Bankart Repair. The study aims to gain insights into how kinesiophobia affects shoulder pain and function after surgery.

Abstract

Background

Kinesiophobia (fear of movement) is a major limiting factor in the return to pre-injury
sport level after surgery of anterior gleno-humeral instability. The study aims to analyze the
prevalence of kinesiophobia in patients with anterior glenohumeral instability treated with
Bankart procedure and the correlation beetween the kinesiophobia and some outcome predictors
of the patology and sociodemographic features.

Methods

A retrospective study was conducted. Patients who underwent arthroscopic bankart
repair starting from December 2018 in our institution, with a minimum of 6 months after the
surgery, were included. A preoperative computed tomography (CT) scan was performed in all
patients. Exclusion criteria were: glenoid bone deficit > 20% of the area of the inferior part of
glenoid, bipolar bone defects with “off-track”pattern, combined treatment with rotator cuff tears,
and/or previous surgery. Primary outcome was the Tampa Scale of Kinesiophobia (TSK-13).
Secondary outcomes were: the Western Ontario Shoulder Instability Index (WOSI), the American
shoulder and elbow score (ASES), the Depression Anxiety Stress Scake 21 (DAS-21), the Tegner
Activity Scale and the H-G Ratio. Univariate and Multivariate analysis was performed to determine
which predictors were independently associated with the kinesiophobia. Significance was set at
<0.05.

Results

The study included 132 patients: 109 males and 23 females. Mean age (+ SD) of patients
was 19 ± 8 years. The mean follow-up was 84 months. The mean pre-operative shoulder
dislocation was 15. 117(89%) patients were performing sport. 19 patients (14.4%) experience a
recurrence of dislocation after surgery. The analysis showed a significant correlation beetween
kinesiophobia and the number of pre-operative shoulder dislocation and both with recurrence of
post-operative shoulder dislocation. All the score (ASES, WOSI, Tegner, DASS-21) in the post-
operative setting showed a significative correlation with Kinesiophobia.

Conclusion

Kinesiophobia after arthroscopic Bankart repair is independently associated with number of pre-
operative shoulder dislocation, recurrence of post-operative shoulder dislocation and score for
subjective evaluation at follow-up.