Over 150 different surgical techniques for treatment of anterior shoulder instability has been suggested that there is no consensus in the orthopedics. This study seeks to compare treatment outcomes of arthroscopic Bankart lesion repair methods with Bristow - Latarjet open surgical technique in patients with anterior shoulder instability. In this cross-sectional study all patients with recurrent shoulder dislocation from 2009-2011 was divided into two groups, arthroscopic Bankart treatment (28 cases) and open Bristow - Latarjet (26 cases) that all were treated by one orthopedic surgeon. Patients were visited in 2,4,6,8 weeks also in the third and sixth month post-op. The visual analog scale (VAS) for patient satisfaction and Walsch-duplay and Rowe score for functional outcomes of treatment were used in six months follow up. These three criteria were analyzed again after recalling the patients. Mean age of 54 patients was 29.46±9.16 years and mean follow-up duration was 23.28 ± 6.2 months. Scores of patients in both groups were not statistically different after analyzing the functional outcomes of treatment by Walsch-duplay and Rowe score after six months and final follow-up. Scores of patients by Walsch-duplay measurement in arthroscopic Bankart and Bristow-Latarjet groups were 98.03±4.37 and 97.88±4.51 respectively and by Rowe index were 97.32±5.52 vs. 97.88±4.51at final follow-up. No recurrence was observed in both groups in final follow up. Patient satisfaction in Bankart and operation groups were 9.4 ±0.68 and 9.47±0.58 (p = 0.69). In anterior shoulder instability, minimally invasive Arthroscopic Bankart procedures almost equal to open Bristow-Latarjet method with regards to shoulder stability, recurrence rate, and range of motion.

Open Bankart surgery is the main treatment procedure in patients with recurrent anterior shoulder dislocation, especially in cases with glenoid bone defect. The goal of this study was to determine the outcomes after open Bankart surgery in cases of recurrent anterior shoulder dislocation with glenoid bone defects and concomitant Hill-Sachs lesions.
Between 2006 and 2010, 89 patients with recurrent anterior shoulder dislocation and concomitant glenoid bone defects (10-30%) and Hill-Sachs lesions undergoing open Bankart surgery were reviewed. The mean follow-up after surgery was 7 years (5.5-9.5 years). The recurrence rate as well as the degree of shoulder pain and daily activity level was determined subjectively based on the visual analogue scale (VAS) and activity daily living scale (ADLs). Shoulder range of motion (ROM) in abduction and external rotation was compared with contralateral side; and finally, the American shoulder and elbow score (ASES) and constant-Murley score (CMS) were calculated.
Over 7 years of follow-up, a total of 15 patients (16.8%) undergoing surgery were found to have instability (3 patients (3.3%) with dislocation and 12 patients with (13.4%) subluxation). Patients with postsurgical instability had significantly larger glenoid bone defects (P=0.0001) and Hill-Sachs lesions (P=0.019) compared to those without instability. The mean loss of forward flexion compared with the normal contralateral side was 4º while the mean loss of external rotation between both sides was 5º. At the final visit, the average VAS was 0.4 (out of 10); ADL was 28.97 (range: 25-30); ASES was 96.1(range: 78.3-100); and the mean CMS value was 93.9(range: 82-100).
Open Bankart surgery with anteroinferior capsular shift for recurrent anterior shoulder dislocation with up to 30% glenoid bone defect and Hill-Sachs lesion provided desirable results in terms of shoulder function and recurrence rate. Bankart surgery is a successful and practical option in these patients and can be considered as an alternative to other procedures.

The treatment of recurrent anterior shoulder dislocation in patients who failed a supervised rehabilitation program is operative stabilization. Anatomical repair addressing the underlying pathology is the preferred method. We hypothesize that Bristow-Latarjet procedure is effective in all types of traumatic recurrent anterior shoulder dislocations, although in cases with Bankart lesion, Bankart operation is certainly preferred. Thirty-five shoulders on which a Bristow-Latarjet operation had been performed on account of traumatic recurrent anterior shoulder instability were followed up for an average of 24.6 months (range: 18 – 51). The clinical outcome was measured according to Walch-Duplay Rating Sheet for Anterior Instability of the Shoulder at the latest follow-up. The clinical outcome was excellent in 11 (31%) patients and good in 24 (69%) patients. Two patients had redislocation that were treated nonoperatively and remained symptom-free at the latest follow-up. Radial nerve palsy occurred in one patient that spontaneously recovered after nine weeks. Although the treatment of anterior shoulder instability in patients with Bankart lesion and intact capsular material (without excessive laxity) is certainly Bankart operation, we claim that in almost all types of anterior shoulder instability, especially in patients with large Hill-Sachs lesions, glenoid bone loss, or excessive capsular laxity, the Bristow-Latarjet operation is associated with good or excellent results and can make the patient satisfied.

Shoulder has the greatest range of motion among our body joints. This makes this joint susceptible to dislocation and subluxation. The most common form of instability of the shoulder is anterior dislocation. Bankart’s essential lesion is the most common cause of recurrent anterior shoulder instability. In this study the results of Bankart operation have been evaluated. Subjects and Thirty cases of recurrent shoulder dislocation underwent open Bankart surgery using anchor suture were selected. These operation were carried out from 1390-1380 in Razi and Emam hospitals in Ahvaz. The cases were evaluated for joint instability، pain according to numerical rating scale، DASH and Rowe Scores، range of motion and movement limitation. Data was analyzed using Fisher exact test and SPSS17 program. The mean age of the patients was 6. 65±33. 7 years. The mean forward elevation، internal rotation، external rotation and abduction were 150، 47، 36 and 156 degrees respectively، which were just a little less than normal lower limits. Mean reduction of external rotation was 5 degree (20-0). According to ROWE score the excellent، good and faire result were 64%، 23% and 13%. DASH score mean was 38. 83 (normal range 66-30). None of them had recurrence or osteoarthritis in radiography. According to the results of this study it seems that open Bankart surgery is an effective method for reducing pain and recurrence of shoulder dislocation.

This is a report of a 17-year-old wrestler who had suffered from a sport injury during an international competition that led to recurrent shoulder dislocation. Physical examination showed that he had a severe ligamentous laxity. In the magnetic resonance images there were combined humeral avulsion of the glenohumeral ligament (HAGL) and Bankart lesions. Combination of Bankart and HAGL lesions, severe ligamentous laxity, being adolescent and requiring a full recovery to resume wrestling professionally, made this case unique. Here we explain his imaging and arthroscopic findings, the technique used for arthroscopic repair, and his midterm follow-up results.

Glenoid bone damages consisting of anterior rim erosion and bony avulsion are very important in decision making for treatment of recurrent dislocation in shoulder joint. This study was aimed to determine the prevalence of these damages in patients with anterior recurrent shoulder dislocation. The study was a cross-sectional study evaluating patients with unstable shoulder joint. Glenoid bone damage was assessed using three dimensional (CT) scan implementing either glenoid width index or by Pico method. Ninety two patients were assessed by glenoid width index and 19 by PICO. Among the first group, 6 patients (6%) had intact shoulder joint and 86 patients (93%) had glenoid lesion including 56 (60.9%) erosions and 30 (32.6%) with bony Bankart. In this group, 60 (65%) patients had Hill-Sachs lesion. Using Pico evaluation, 8 (42%) had bony Bankart, 9 (47%) erosion and 2 (10%) no lesion, and 8 (42%) Hill-Sachs. There was no significant correlation between severities of glenoid bone loss with patients''frequency of dislocations. Patients with convulsion-induced shoulder dislocation had the most severe bone loss. The CT scan should be done early in recurrent dislocation because severe bony damage could occur even after few dislocations. The overall prevalence of glenoid bone damage including bony Bankart and erosion are high in recurrent anterior dislocation. This is particularly emphasized in patients with seizure.

Anterior shoulder instability with minimal glenoid bone loss has several options fo r Bankart repair. We aimed to evaluate the results of a modified technique using two anchors with double and single loaded suture (three stitches in total) in arthroscopic Bankart surgery. Thirty-eight patients underwent arthroscopic Bankart surgery and were assessed after an average 40 months follow-up. They underwent two-anchor repairs with single loaded of a high-strength, non-absorbable braided suture and double loaded suture. The participants were assessed preoperatively and postoperatively in terms of range of motion, CONSTANT Scores, and visual analogue scale (VAS). Recurrence of subluxations, dislocations, and other complications were also assessed. The mean follow-up time was 40.1±6.99 months. The mean Constant scores were 80.32±4.81 (95%CI: 78.73-81.90) preoperatively and 94.45±3.71 (95%CI: 93.23-95.67) postoperatively (P = < 0.001). A significant change was noted for the VAS score from 2.74±0.95 (95%CI: 2.42-3.05) to 0.63±0.75 (95%CI: 0.38-0.88) (P < 0.001). Mean preoperative external rotation and forward flexion were also preserved postoperatively (P < 0.001). The incidence of nonclinical subluxation was 2/38, 5.3%, however no case of clinical subluxation or re-dislocation was occurred; infection or neurovascular complications have not been observed as well. Using two anchors with single and double loaded arthroscopic suture showed acceptable clinical results for traumatic anterior shoulder instability repair in properly selected patients. Level of evidence: IV

Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared.

This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software.

Six patients (16.22%) had inappropriate condition with ROWE score (score less than 75); of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78). Nine patients (24.32%) had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67). Finally, 22 patients (59.46%) showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56). According to Fisher’s exact test, there were no significant differences between the two groups (P = 0.15).

The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method.

Introduction & Shoulder joint is the most common articular dislocations in the body. There are many surgical techniques for the treatment of recurrent shoulder dislocation. The aim of the study is to evaluate the short-term results of surgical technique of modified Bankart repair for recurrent anterior shoulder instability. Twenty patients underwent an operation at Tabriz Shohada hospital, from May 2005 to december 2007 and were followed up for at least 18 months. The data was analyzed by descriptive statistical methods. There were 85% male and 15%female participants in the study, with the average age of 24.7 years(14-46years). The mean number of dislocation episode before surgery was 6(3-11). Two had minor glenoid rim fracture. There was no case of rotator cuff tear. During the follow up after surgery, two patients had recurrence of dislocation. The mean Rowe score was 94 and no infection or neurological complication was reported. Average external rotation loss was 5º. According to the above-mentioned data, modified bankart procedure is an acceptable method for treatment of recurrent dislocation of the shoulder.

45 patients (40 male & 5 female) with recurrent anterior shoulder instability were operated from 1993 to 2001. The mean age was 27 years (18-46) and 95% were right handed and 5% left handed. Instability was on right side in 54.4% left side in 38.6% and bilateral in 6.9%. 15 pt’s were operated with classic Rowe procedure and 30 pt’s with using modified anchor screw, and follow up period was 37.6 mounths (12-110), Bankart lesion was found in 100% of cases. Subscapularis muscle lesion, Interval lesion and capsular laxity in 9.3%, 14.5% and 47.6% respectively. Glenoid fracture and loose body in 2.9 and 29% respectively. In 75% of pt’s Hill-Sachs lesion was found that was moderate to sever type in 88%. At follow up study, First group (with no modified screw), there was no apprehension sign in 53.3% and redislocation in one patient and full range of motion in all cases. In secound group (with screw), no apprehension in 79% and no redislocation was found and range of motion was full in 93%. The first group has little or no limitation at their function in 90% and secound group in 96%. According to rowe scores, results were 53.3% excellent, 26.6% good 13.3% fair and poor in one case for first group and 69% excellent, 15.5% good and 15.5% fair without poor result in sceound group. In conclusion, using modified anchor screw for bankart procedure is easy to do, needs less instruments, with low surgical trauma, shortoperation time, and low complication rate and over all good results.