Background
Arthroscopic Bankart operation using suture anchors has become the most common surgery to treat post-traumatic anteroinferior instability of the shoulder joint. Recent studies suggested that recurrence of the instability may be higher, reaching 35–40% in patients aged less than 25 years, and the results tend to get worse after long-term follow-up. Open Bankart operation, revision arthroscopic Bankart, and Latarjet operation can be used to restore stability. The authors recommended Latarjet reconstruction in cases of engaging Hill-Sachs lesion, poor capsular quality, or in cases of hyperlaxity, making it an ideal operation to treat both bony and soft tissue pathology after failed capsulolabral reconstructions.
Patients and methods
Eleven patients with failed arthroscopic Bankart repair were operated with open Laterjet technique between January 2011 and December 2014. All patients had a failure (recurrent dislocation or subluxation) after arthroscopic Bankart repair for post-traumatic anteroinferior shoulder instability. The mean age of the patients was 20.8 years (17–30 years). There were eight males and three females. All patients had recurrent subluxation or dislocation and positive anterior apprehension sign as an indication for revision surgery. All patients were examined preoperatively with plain radiographs (anteroposterior and axillary views) and computed tomography scans. Functional outcome and stability were assessed using Western Ontario Shoulder Instability score.
Results
All patients in the study had a stable shoulder at follow-up, except one patient who had symptoms of instability. Functionally, the mean Western Ontario Shoulder Instability was 27.8% (range: 10–80%). The Score was better in patients with a stable shoulder compared with the one patient with an unstable shoulder. There were no intraoperative or postoperative complications.
Conclusion
Open Latarjet operation is a good option for failed arthroscopic Bankart repair. The instability recurrence rate is acceptable, and the reoperation rate was low.