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Orthop Traumatol Sur · Dec 2015
Ten-year follow-up of acute arthroscopic Bankart repair for initial anterior shoulder dislocation in young patients.
- V Chapus, G Rochcongar, V Pineau, É Salle de Chou, and C Hulet.
- Département d'orthopédie-traumatologie, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France.
- Orthop Traumatol Sur. 2015 Dec 1; 101 (8): 889-93.
IntroductionEarly treatment of initial anterior glenohumeral dislocation in young patients is controversial and the interest of surgery, and notably arthroscopic stabilization, has not been demonstrated. A prospective study was therefore performed to assess (1) short-to-medium-term recurrence rate, (2) functional outcome, and (3) and medium-term osteoarthritis rate.HypothesisEarly arthroscopic stabilization by anterior capsule-labrum reinsertion after initial anterior shoulder dislocation is associated with low recurrence rate.Materials And MethodsTwenty-one patients with initial anterior dislocation were included between June 2002 and February 2004. All patients underwent arthroscopic Bankart repair within 30 days of dislocation. Patients were followed up prospectively, with clinical (Duplay and Constant scores) and radiological assessment (osteoarthritis).ResultsThere were 5 recurrent dislocations (25%); 2 patients reported sensations of subluxation: i.e., 7 failures (35%). Mean Walch-Duplay score at 10 years was 88±1 (range, 30-100) and mean Rowe score 86±22 (range, 35-100). There was significant internal rotation deficit of one vertebral level between operated and contralateral shoulder (P < 0.005). At 10 years, 3 shoulders (15%) showed Samilson grade 1 centered glenohumeral osteoarthritis.ConclusionEarly arthroscopic capsule-labrum reinsertion by the Bankart technique in the month following initial anterior dislocation of the shoulder in patients under 25 years of age provided a low recurrence rate (35%) compared to the literature, including dislocation (25%) and subluxation (10%). Functional outcome was satisfactory, and osteoarthritis rate was low (15% Samilson grade 1).Level Of EvidenceIV, prospective non-comparative study.Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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