Risk factors for recurrence after Bankart repair a systematic review

P. Randelli, V. Ragone, S. Carminati, P. Cabitza

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Purpose: Arthroscopic Bankart repair of anterior shoulder instability is a common practice in orthopedics. The aim of this study was to evaluate pre-operative risks factors associated with recurrent instability and to delineate possible indications for revision surgery. Methods: A systematic review was performed including the following keywords: arthroscopy, Bankart repair, anterior shoulder instability, recurrence of instability, suture anchors and treatment outcome. Studies eligible for inclusion in the review were clinical trials published in the last 10 years investigating patients with anterior shoulder instability managed by an arthroscopic repair technique with suture anchors. The studies had to report data about recurrence of instability and investigational parameters (risk factors) that influenced the results referred to the rate of recurrence. Twenty-four articles were identified that met the inclusion criteria and underwent further review. Data from these studies were collected, and the risk of treatment failure was statistically recalculated. An estimate of the overall recurrence rate was obtained by pooling data about failure from the trials. Results: The rate of recurrent instability at 10 years of follow-up ranged from 3. 4 to 35 %. Epidemiological parameters significantly associated with the recurrence of instability were age below 22 years old, male gender, the number of preoperative dislocations and participation in competitive sports. Surgical parameters significantly associated with recurrence of instability were repair with fewer than three anchors and the use of knotless anchors. The patho-anatomical factors significantly associated with recurrences were substantial associated glenoid or humeral head bone loss and the presence of anterior labroligamentous periosteal sleeve avulsion. Conclusions: Knowledge of risk factors for post-operative outcomes allows surgeons to provide appropriate preoperative counselling to patients and support more realistic expectations. An accurate analysis of causes of failure should enable the correct revision strategy to be adopted. Level of evidence: II.

Original languageEnglish
Pages (from-to)2129-2138
Number of pages10
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 2012

Fingerprint

Recurrence
Suture Anchors
Humeral Head
Arthroscopy
Treatment Failure
Reoperation
Sports
Orthopedics
Meta-Analysis
Counseling
Clinical Trials
Bone and Bones

Keywords

  • Anterior shoulder instability
  • Arthroscopy
  • Bankart repair
  • Suture anchors

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Risk factors for recurrence after Bankart repair a systematic review. / Randelli, P.; Ragone, V.; Carminati, S.; Cabitza, P.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 20, No. 11, 11.2012, p. 2129-2138.

Research output: Contribution to journalArticle

Randelli, P. ; Ragone, V. ; Carminati, S. ; Cabitza, P. / Risk factors for recurrence after Bankart repair a systematic review. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2012 ; Vol. 20, No. 11. pp. 2129-2138.
@article{f2c6873906c04349b2156d5ca0d4c559,
title = "Risk factors for recurrence after Bankart repair a systematic review",
abstract = "Purpose: Arthroscopic Bankart repair of anterior shoulder instability is a common practice in orthopedics. The aim of this study was to evaluate pre-operative risks factors associated with recurrent instability and to delineate possible indications for revision surgery. Methods: A systematic review was performed including the following keywords: arthroscopy, Bankart repair, anterior shoulder instability, recurrence of instability, suture anchors and treatment outcome. Studies eligible for inclusion in the review were clinical trials published in the last 10 years investigating patients with anterior shoulder instability managed by an arthroscopic repair technique with suture anchors. The studies had to report data about recurrence of instability and investigational parameters (risk factors) that influenced the results referred to the rate of recurrence. Twenty-four articles were identified that met the inclusion criteria and underwent further review. Data from these studies were collected, and the risk of treatment failure was statistically recalculated. An estimate of the overall recurrence rate was obtained by pooling data about failure from the trials. Results: The rate of recurrent instability at 10 years of follow-up ranged from 3. 4 to 35 {\%}. Epidemiological parameters significantly associated with the recurrence of instability were age below 22 years old, male gender, the number of preoperative dislocations and participation in competitive sports. Surgical parameters significantly associated with recurrence of instability were repair with fewer than three anchors and the use of knotless anchors. The patho-anatomical factors significantly associated with recurrences were substantial associated glenoid or humeral head bone loss and the presence of anterior labroligamentous periosteal sleeve avulsion. Conclusions: Knowledge of risk factors for post-operative outcomes allows surgeons to provide appropriate preoperative counselling to patients and support more realistic expectations. An accurate analysis of causes of failure should enable the correct revision strategy to be adopted. Level of evidence: II.",
keywords = "Anterior shoulder instability, Arthroscopy, Bankart repair, Suture anchors",
author = "P. Randelli and V. Ragone and S. Carminati and P. Cabitza",
year = "2012",
month = "11",
doi = "10.1007/s00167-012-2140-1",
language = "English",
volume = "20",
pages = "2129--2138",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Risk factors for recurrence after Bankart repair a systematic review

AU - Randelli, P.

AU - Ragone, V.

AU - Carminati, S.

AU - Cabitza, P.

PY - 2012/11

Y1 - 2012/11

N2 - Purpose: Arthroscopic Bankart repair of anterior shoulder instability is a common practice in orthopedics. The aim of this study was to evaluate pre-operative risks factors associated with recurrent instability and to delineate possible indications for revision surgery. Methods: A systematic review was performed including the following keywords: arthroscopy, Bankart repair, anterior shoulder instability, recurrence of instability, suture anchors and treatment outcome. Studies eligible for inclusion in the review were clinical trials published in the last 10 years investigating patients with anterior shoulder instability managed by an arthroscopic repair technique with suture anchors. The studies had to report data about recurrence of instability and investigational parameters (risk factors) that influenced the results referred to the rate of recurrence. Twenty-four articles were identified that met the inclusion criteria and underwent further review. Data from these studies were collected, and the risk of treatment failure was statistically recalculated. An estimate of the overall recurrence rate was obtained by pooling data about failure from the trials. Results: The rate of recurrent instability at 10 years of follow-up ranged from 3. 4 to 35 %. Epidemiological parameters significantly associated with the recurrence of instability were age below 22 years old, male gender, the number of preoperative dislocations and participation in competitive sports. Surgical parameters significantly associated with recurrence of instability were repair with fewer than three anchors and the use of knotless anchors. The patho-anatomical factors significantly associated with recurrences were substantial associated glenoid or humeral head bone loss and the presence of anterior labroligamentous periosteal sleeve avulsion. Conclusions: Knowledge of risk factors for post-operative outcomes allows surgeons to provide appropriate preoperative counselling to patients and support more realistic expectations. An accurate analysis of causes of failure should enable the correct revision strategy to be adopted. Level of evidence: II.

AB - Purpose: Arthroscopic Bankart repair of anterior shoulder instability is a common practice in orthopedics. The aim of this study was to evaluate pre-operative risks factors associated with recurrent instability and to delineate possible indications for revision surgery. Methods: A systematic review was performed including the following keywords: arthroscopy, Bankart repair, anterior shoulder instability, recurrence of instability, suture anchors and treatment outcome. Studies eligible for inclusion in the review were clinical trials published in the last 10 years investigating patients with anterior shoulder instability managed by an arthroscopic repair technique with suture anchors. The studies had to report data about recurrence of instability and investigational parameters (risk factors) that influenced the results referred to the rate of recurrence. Twenty-four articles were identified that met the inclusion criteria and underwent further review. Data from these studies were collected, and the risk of treatment failure was statistically recalculated. An estimate of the overall recurrence rate was obtained by pooling data about failure from the trials. Results: The rate of recurrent instability at 10 years of follow-up ranged from 3. 4 to 35 %. Epidemiological parameters significantly associated with the recurrence of instability were age below 22 years old, male gender, the number of preoperative dislocations and participation in competitive sports. Surgical parameters significantly associated with recurrence of instability were repair with fewer than three anchors and the use of knotless anchors. The patho-anatomical factors significantly associated with recurrences were substantial associated glenoid or humeral head bone loss and the presence of anterior labroligamentous periosteal sleeve avulsion. Conclusions: Knowledge of risk factors for post-operative outcomes allows surgeons to provide appropriate preoperative counselling to patients and support more realistic expectations. An accurate analysis of causes of failure should enable the correct revision strategy to be adopted. Level of evidence: II.

KW - Anterior shoulder instability

KW - Arthroscopy

KW - Bankart repair

KW - Suture anchors

UR - http://www.scopus.com/inward/record.url?scp=84867849322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867849322&partnerID=8YFLogxK

U2 - 10.1007/s00167-012-2140-1

DO - 10.1007/s00167-012-2140-1

M3 - Article

VL - 20

SP - 2129

EP - 2138

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 11

ER -