Purpose: Arthroscopic Bankart repair (ABR) provides satisfactory results for recurrent anterior shoulder instability, but the high recurrence rate post-ABR remain a concern. One of the adjunct procedures proposed to improve ABR results is arthroscopic rotator interval closure (ARIC). This study prospectively evaluated the outcomes of ABRs alone compared to combined ABR + ARIC and identified risk factors related to failure of each procedure.
Methods: Thirty-nine consecutive patients (mean age 23.1 (18.3-37.5) years; 37 males) underwent arthroscopic stabilization for recurrent anterior traumatic shoulder instability. Twenty patients underwent ABR alone and 19 underwent ABR + ARIC. Remplissage was added when glenoid engagement was observed during surgery. All patients were prospectively followed, and their postoperative courses were reviewed and functionally assessed at the last visit.
Results: The re-dislocation rate was higher in the ABR + ARIC group compared to the ABR only group at a mean follow-up of 4.2 (2-5.6) years (3 vs. 0, P = 0.06). More subluxations were found in the ABR only group (2 vs. 1, respectively; P = 0.58). The final limitation of range of motion (ROM) compared with the preoperative ROM was similar in both groups. Remplissage procedures were performed more often in the ABR only group [12 (60%) vs. 4 (21%), P = 0.013].
Conclusions: ARIC performed as an adjunct to ABR showed no superiority in attaining value-added stability compared to ABR alone. Adding a remplissage procedure may achieve better stability.
Level of evidence: Level 2.
Keywords: Arthroscopy; Bankart repair; Hyperlaxity; Remplissage; Rotator interval; Shoulder dislocation.