13:20
Published August 25, 2021

Revision Arthroscopic Bankart Repair for Recurrent Anterior Shoulder Instability

Background Anterior shoulder instability is a common shoulder problem, affecting 1% to 2% of the general population, with reported rates ranging from 8 to 17 dislocations per 100,000 person-years. Arthroscopic Bankart repair is the most common procedure performed to manage anterior shoulder instability, particularly in patients with soft-tissue disruption and minimal glenohumeral bone loss; however, concern exists with regard to recurrent shoulder instability rates of 30% reported at a follow-up of more than 10 years. Although a more invasive, open approach often is indicated in patients in whom prior stabilization fails, revision arthroscopic Bankart repair may be successful in appropriately indicated patients. Purpose This video and case presentation demonstrate a technique for revision arthroscopic Bankart repair. Methods The video provides an overview of the pathogenesis, diagnosis, and management of anterior shoulder instability in a patient in whom prior stabilization failed. The case presentation of a 19-year-old man with recurrent anterior shoulder instability 1 year after arthroscopic Bankart repair is discussed. The patient fully recovered after the index procedure but sustained a recurrent shoulder dislocation during a basketball game. The surgical technique for revision Bankert repair is demonstrated. Results The procedure was successfully performed, and the anatomy was restored. The patient was advanced through a standardized rehabilitation protocol. At a follow-up of 1 year, the patient’s pain had substantially improved. The patient denied any recurrence or sensation of instability. The patient returned to full functional capacity, including sports activity. Conclusion Arthroscopic Bankart repair is a useful procedure for appropriately indicated patients in whom prior shoulder stabilization fails. The procedure avoids the potential complications of a more invasive procedure. Early results suggest good to excellent radiographic and clinical outcomes.