PMID- 36740291
OWN - NLM
STAT- MEDLINE
DCOM- 20230207
LR  - 20230217
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 39
IP  - 3
DP  - 2023 Mar
TI  - Increased Failure Rates After Arthroscopic Bankart Repair After Second 
      Dislocation Compared to Primary Dislocation With Comparable Clinical Outcomes.
PG  - 682-688
LID - S0749-8063(22)00631-4 [pii]
LID - 10.1016/j.arthro.2022.10.012 [doi]
AB  - PURPOSE: The purpose of this study was to compare rates of recurrent dislocation 
      and postsurgical outcomes in patients undergoing arthroscopic Bankart repair for 
      anterior shoulder instability immediately after a first-time traumatic anterior 
      dislocation versus patients who sustained a second dislocation event after 
      initial nonoperative management. METHODS: A retrospective chart review was 
      performed of patients undergoing primary arthroscopic stabilization for anterior 
      shoulder instability without concomitant procedures and minimum 2-year clinical 
      follow-up. Primary outcome was documentation of a recurrent shoulder dislocation. 
      Secondary clinical outcomes included range of motion, Visual Analog Scale (VAS), 
      American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Shoulder Activity 
      Scale (SAS). RESULTS: Seventy-seven patients (mean age 21.3 years +/- 7.3 years) 
      met inclusion criteria. Sixty-three shoulders underwent surgical stabilization 
      after a single shoulder dislocation, and 14 underwent surgery after 2 
      dislocations. Average follow-up was 35.9 months. The rate of recurrent 
      dislocation was significantly higher in the 2-dislocation group compared to 
      single dislocations (42.8% vs 14.2%, P = .03). No significant difference was 
      present in range of motion, VAS, ASES, and SAS scores. The minimal clinically 
      important difference (MCID) was 1.4 for VAS and 1.8 for SAS scores. The MCID was 
      met or exceeded in the primary dislocation group in 31/38 (81.6%) patients for 
      VAS, 23/31 (74.1%) for ASES, and 24/31 for SES (77.4%) scores. For the second 
      dislocation cohort, MCID was met or exceeded in 7/9 (77.8%) for VAS, 4/7 (57.1%) 
      for ASES, and 5/7 for SES (71.4%) scores. CONCLUSION: Immediate arthroscopic 
      surgical stabilization after a first-time anterior shoulder dislocation 
      significantly decreases the risk of recurrent dislocation in comparison to those 
      who undergo surgery after 2 dislocation events, with comparable clinical outcome 
      scores. These findings suggest that patients who return to activities after a 
      primary anterior shoulder dislocation and sustain just 1 additional dislocation 
      event are at increased risk of a failing arthroscopic repair. STUDY DESIGN: 
      Retrospective comparative study; Level of evidence, 3.
CI  - Copyright (c) 2022 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Fox, Michael A
AU  - Fox MA
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: 
      michaelfox7dg@gmail.com.
FAU - Drain, Nicholas P
AU  - Drain NP
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Rai, Ajinkya
AU  - Rai A
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Zheng, Aaron
AU  - Zheng A
AD  - University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
FAU - Carlos, Noel B
AU  - Carlos NB
AD  - University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
FAU - Serrano Riera, Rafael
AU  - Serrano Riera R
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Sabzevari, Soheil
AU  - Sabzevari S
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Hughes, Jonathan D
AU  - Hughes JD
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Popchak, Adam
AU  - Popchak A
AD  - Department of Physical Therapy, University of Pittsburgh, Pittsburgh, 
      Pennsylvania, USA.
FAU - Rodosky, Mark W
AU  - Rodosky MW
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Lesniak, Bryson P
AU  - Lesniak BP
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Lin, Albert
AU  - Lin A
AD  - Pittsburgh Shoulder Institute, Department of Orthopedic Surgery, University of 
      Pittsburgh, Pittsburgh, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20221207
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2023 Mar;39(3):689-691. PMID: 36740292
MH  - Humans
MH  - Young Adult
MH  - Adult
MH  - *Shoulder Dislocation/surgery/complications
MH  - *Joint Instability/surgery
MH  - *Shoulder Joint/surgery
MH  - Retrospective Studies
MH  - Recurrence
MH  - *Joint Dislocations/surgery
MH  - Arthroscopy/methods
EDAT- 2023/02/06 06:00
MHDA- 2023/02/08 06:00
CRDT- 2023/02/05 20:56
PHST- 2022/04/21 00:00 [received]
PHST- 2022/09/23 00:00 [revised]
PHST- 2022/10/10 00:00 [accepted]
PHST- 2023/02/05 20:56 [entrez]
PHST- 2023/02/06 06:00 [pubmed]
PHST- 2023/02/08 06:00 [medline]
AID - S0749-8063(22)00631-4 [pii]
AID - 10.1016/j.arthro.2022.10.012 [doi]
PST - ppublish
SO  - Arthroscopy. 2023 Mar;39(3):682-688. doi: 10.1016/j.arthro.2022.10.012. Epub 2022 
      Dec 7.