2015 ISAKOS Biennial Congress ePoster #2314

Long-Term Results After Open Bankart-Repair and Capsular Shift for Recurrent Posttraumatic Anterior Shoulder Instability

Thomas Kappe, MD, Prof., Ulm GERMANY
Julia Tekolf, MD, Ulm GERMANY
Heiko Reichel, Prof., Ulm GERMANY
Dept. for Orthopaedic Surgery, University of Ulm, Ulm, GERMANY

FDA Status Not Applicable

Summary: In this study on the long-term results after open Bankart-Repair and capsular shift for recurrent posttraumatic anterior shoulder instability, a redislocation rate of 13% and a subtle yet consistent rate of impaired shoulder function was found 13.6 years after the operation.

Abstract:

Introduction

Nowadays, arthroscopic techniques are the gold standard in the treatment of shoulder instability. In contrast to open stabilization procedures, the risk of subscapularis insufficiency and the loss of external rotatation are perceived to be lower with arthroscopic approaches. The aim of the present study was to evaluate the long-term results of open Bankart-Repair and capsular shift for posttraumatic anterior shoulder instability.

Material And Methods

Sixty-two shoulder joints in 60 patients, 18 women and 42 men, with a mean age of 30.3 ± 9.3 years at the time of operation were evaluated 13.6 years (range, 10.9 to 16.7 years) after open Bankart repair and capsular shift for posttraumatic anterior shoulder instability. Investigation included the Western Ontario Shoulder Instability (WOSI) Score, Constant Score, Subjective Shoulder Value (SSV), and American Shoulder and Elbow Surgeons (ASES) Score.

Results

Eight cases of recurrent shoulder dislocation occured during the follow-up period (13%). The mean WOSI Score was 77 compared to 89 on the contralateral, healthy side, the age- and gender matched Constant Score was 94% and 103%, the SSV was 77% and 87%, and the ASES Score was 89 and 94 points, respectively. Deep external rotation was 67 and 73°. Follow-up X-rays were available in 18 shoulder joints, 7 of which displayed signs of osteoarthritis (Samilson and Prieto stage one in 4 and stage two in 3 shoulder joints).

Conclusion

Long-term results after open Bankart repair and capsular shift for posttraumatic anterior shoulder instability are satisfactory. A normal shoulder function is rarely acchieved. Minor yet consistent deficits were found concerning external rotation. Thirty-nine percent of shoulder joint had signs of osteoarthritis. However, it has yet to be determined if the comparable redislocation rates of contemporary arthroscopic procedures lead to better functional results in the long term.