Revision of failed arthroscopic bankart repairs

BACKGROUND: The results following open revision surgery following a failed arthroscopic Bankart procedure are not well documented. PURPOSE: To evaluate the results of patients with a failed arthroscopic Bankart repair treated with a traditional, open Bankart repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Thirty patients (28 male and 2 female) who had a mean age of 24 years (range 15-36) at the time of operation were evaluated. The mean interval from the time of the operation to the final follow-up was 46 months (range 24-55). The rating systems of Rowe and the University of California at Los Angeles (UCLA) were recorded preoperatively and at the time of the final evaluation. RESULTS: After open repair, mean modified Rowe scores improved from 25 preoperatively to 84.2 points. The results were excellent in 2 (6.7%), good in 24 (80%), and fair in 4 (13.3%); there were no poor results. The UCLA shoulder score improved from a mean of 17 points preoperatively to 29 points (P = .001 for all comparisons). Twenty-six patients (87%) did not have an anchor placement inferior to the 4-o'clock position for a right shoulder or the 8-o'clock position for the left shoulder after the index arthroscopic repair. There were no rotator interval closures performed at the index arthroscopic Bankart repair, and 10 patients (33%) required an interval closure at the open revision procedure. Twenty-five patients (83%) immobilized the operated arm in a sling for less than 2 weeks following the index arthroscopic repair. CONCLUSION: Patients with failed arthroscopic Bankart repairs can be successfully treated with a revision, open Bankart repair. Inadequate postoperative immobilization, large rotator intervals, and improper anchor placement are possible risk factors that may increase the incidence of failure of an arthroscopic Bankart repair.