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Risk factors for recurrence following arthroscopic Bankart repair: a systematic review.
Bulleit, Clark H; Hurley, Eoghan T; Jing, Crystal; Hinton, Zoe W; Doyle, Tom R; Anakwenze, Oke A; Klifto, Christopher S; Dickens, Jonathan F; Lau, Brian C.
Afiliación
  • Bulleit CH; Department of Orthopaedics, Duke University, Durham, NC, USA. Electronic address: clark.bulleit@duke.edu.
  • Hurley ET; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Jing C; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Hinton ZW; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Doyle TR; Sports Surgery Clinic, Santry, Dublin, Ireland.
  • Anakwenze OA; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Klifto CS; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Dickens JF; Department of Orthopaedics, Duke University, Durham, NC, USA.
  • Lau BC; Department of Orthopaedics, Duke University, Durham, NC, USA.
J Shoulder Elbow Surg ; 33(11): 2539-2549, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38852707
ABSTRACT

BACKGROUND:

Recurrent instability remains a major source of morbidity following arthroscopic Bankart repair. Many risk factors and predictive tools have been described, but there remains a lack of consensus surrounding individual risk factors and their contribution to outcomes. The purpose of this study is to systematically review the literature to identify and quantify risk factors for recurrence following arthroscopic Bankart repair.

METHODS:

A literature search was performed using the PubMed/MEDLINE databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were included if they evaluated risk factors for recurrent instability following arthroscopic Bankart repair.

RESULTS:

Overall, 111 studies were included in the analysis, including a total of 19,307 patients and 2750 episodes of recurrent instability with 45 risk factors described. Age at operation was reported by 60 studies, with 35 finding increased risk at younger ages. Meta-analysis showed a 2-fold recurrence rate of 27.0% (171 of 634) for patients <20 years old compared with 13.3% (197 of 1485) for older patients (P < .001). Seventeen studies completed multivariable analysis, 13 of which were significant (odds ratio 1.3-14.0). Glenoid bone loss was evaluated by 39 studies, with 20 finding an increased risk. Multivariable analysis in 9 studies found odds ratios ranging from 0.7 to 35.1; 6 were significant. Off-track Hill-Sachs lesions were evaluated in 21 studies (13 significant), with 3 of 4 studies that conducted multivariable analysis finding a significant association with odds ratio of 2.9-8.9 of recurrence. The number of anchors used in repair was reported by 25 studies, with 4 finding increased risk with fewer anchors. Pooled analysis demonstrated a 25.0% (29 of 156) risk of recurrence with 2 anchors, compared with 18.1% (89 of 491) with 3 or more anchors (P = .06). Other frequently described risk factors included glenohumeral joint hyperlaxity (46% of studies reporting a significant association), number of preoperative dislocations (31%), contact sport participation (20%), competitive sport participation (46%), patient sex (7%), and concomitant superior labral anterior-posterior tear (0%).

CONCLUSION:

Younger age, glenoid bone loss, and off-track Hill-Sachs lesions are established risk factors for recurrence following arthroscopic Bankart repair. Other commonly reported risk factors included contact and competitive sports participation, number of fixation devices, and patient sex.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Recurrencia / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: J Shoulder Elbow Surg Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroscopía / Recurrencia / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: J Shoulder Elbow Surg Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos