Bankart versus Latarjet operation as a revision procedure after a failed arthroscopic Bankart repair.

Arthroscopic Bankart anterior shoulder instability open Latarjet patient reported outcome revision shoulder dislocation

Journal

JSES international
ISSN: 2666-6383
Titre abrégé: JSES Int
Pays: United States
ID NLM: 101763461

Informations de publication

Date de publication:
Jun 2020
Historique:
entrez: 4 6 2020
pubmed: 4 6 2020
medline: 4 6 2020
Statut: epublish

Résumé

An arthroscopic Bankart operation is the most common operative procedure to treat shoulder instability. In case of recurrence, both Bankart and Latarjet procedures are used as revision procedures. The purpose of this study was to compare the re-recurrence rate of instability and clinical results after arthroscopic revision Bankart and open revision Latarjet procedures following failed primary arthroscopic Bankart operations. Consecutive patients operatively treated for shoulder instability at Turku University Hospital between 2002 and 2013 were analyzed. Patients who underwent a primary arthroscopic Bankart operation followed by a recurrence of instability and underwent a subsequent arthroscopic Bankart or open Latarjet revision operation with a minimum of 1 year of follow-up were called in for a follow-up evaluation. The re-recurrence of instability, Subjective Shoulder Value, and Western Ontario Shoulder Instability index were assessed. Of 69 patients, 48 (dropout rate, 30%) were available for follow-up. Recurrent instability symptoms occurred in 13 patients (43%) after the revision Bankart procedure and none after the revision Latarjet procedure. A statistically and clinically significant difference in the Western Ontario Shoulder Instability index was found between the patients after the revision Bankart and revision Latarjet operations (68% and 88%, respectively; The redislocation rate after an arthroscopic revision Bankart operation is high. Furthermore, patient-reported outcomes remain poor after a revision Bankart procedure compared with a revision Latarjet operation. We propose that in cases of recurring instability after a failed primary Bankart operation, an open Latarjet revision should be considered.

Sections du résumé

BACKGROUND BACKGROUND
An arthroscopic Bankart operation is the most common operative procedure to treat shoulder instability. In case of recurrence, both Bankart and Latarjet procedures are used as revision procedures. The purpose of this study was to compare the re-recurrence rate of instability and clinical results after arthroscopic revision Bankart and open revision Latarjet procedures following failed primary arthroscopic Bankart operations.
METHODS METHODS
Consecutive patients operatively treated for shoulder instability at Turku University Hospital between 2002 and 2013 were analyzed. Patients who underwent a primary arthroscopic Bankart operation followed by a recurrence of instability and underwent a subsequent arthroscopic Bankart or open Latarjet revision operation with a minimum of 1 year of follow-up were called in for a follow-up evaluation. The re-recurrence of instability, Subjective Shoulder Value, and Western Ontario Shoulder Instability index were assessed.
RESULTS RESULTS
Of 69 patients, 48 (dropout rate, 30%) were available for follow-up. Recurrent instability symptoms occurred in 13 patients (43%) after the revision Bankart procedure and none after the revision Latarjet procedure. A statistically and clinically significant difference in the Western Ontario Shoulder Instability index was found between the patients after the revision Bankart and revision Latarjet operations (68% and 88%, respectively;
CONCLUSIONS CONCLUSIONS
The redislocation rate after an arthroscopic revision Bankart operation is high. Furthermore, patient-reported outcomes remain poor after a revision Bankart procedure compared with a revision Latarjet operation. We propose that in cases of recurring instability after a failed primary Bankart operation, an open Latarjet revision should be considered.

Identifiants

pubmed: 32490416
doi: 10.1016/j.jseint.2020.01.004
pii: S2666-6383(20)30014-1
pmc: PMC7256887
doi:

Types de publication

Journal Article

Langues

eng

Pagination

292-296

Informations de copyright

© 2020 The Authors.

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Auteurs

Sami Elamo (S)

Division of Musculoskeletal Diseases, Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.
Department of Orthopaedics and Traumatology, Satakunta Central Hospital, Pori, Finland.

Liisa Selänne (L)

Division of Musculoskeletal Diseases, Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.

Kaisa Lehtimäki (K)

Division of Musculoskeletal Diseases, Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.

Juha Kukkonen (J)

Department of Orthopaedics and Traumatology, Satakunta Central Hospital, Pori, Finland.

Saija Hurme (S)

Department of Biostatistics, University of Turku, Turku, Finland.

Tommi Kauko (T)

Auria Clinical Informatics, Hospital District of Southwest Finland, Turku, Finland.

Ville Äärimaa (V)

Division of Musculoskeletal Diseases, Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.

Classifications MeSH