LONG-TERM RESULTS OF THE BANKART OPERATION: REVIEW OF 50 CASES WITH MEAN 26 YEARS FOLLOW-UP

Abstract

Purpose of the study: The purpose of this study was to assess at more than twenty years follow-up, the results achieved with the Bankart operation, focusing on functional and radiographic outcome of the glenohumeral joint in patients operated on when they were young.

Materials and Methods: This retrospective analysis reviewed clinically and radiographically patients who underwent shoulder surgery for instability between 1971 and 1986. The Bankart operation was performed in all patients followed systematically by immobilisation. Self-controlled rehabilitation was the rule. The clinical assessment used thed Duplay and Rowe scores. The Prieto and Samilson radiographic score (four stages) was noted.

Results: Mean follow-up was 26 years for 49 patients (50 shoulders). There were three women and 46 men (sex ratio = 15.3), mean age 25 years at surgery. Eighty percent practiced competition sports (a contact sport for 72%). The time from the first dislocation to surgery was four years on average. The rate of recurrence was 16%. All recurrences were provoked by a violent accident. 94% of patients returned to sports activities (on average 4.6 months after surgery), 80% at the same level. 86% of patients were satisfied. Mean Duplay and Rowe scores were 81.3 and 82.2 respectively. Average deficiency of external rotation was 9° compared with the contralateral side. Normal radiographs were noted for 13 shoulders (26%). The Prieto and Samilson classification was: stage I (n=18), stage II (n=5), stage III (n=5) and stage IV (n=1).

Discussion: In this cohort with 80% competition sports athletes and 94% return to sports activities after surgery, the Bankart operation demonstrated its efficacy for contact sports. The rate of osteoarthritis after this operation is comparable with that observed with other types of bone blocks, but the follow-up here was twice as long. The deficit in external rotation was not greater than with non-anatomic operations.