The Journal of Bone and Joint Surgery (American) 85:1511-1518 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.
Arthroscopic Anterior Stabilization of the Shoulder
Two to Six-Year Follow-up
Seung-Ho Kim, MD,
Kwon-Ick Ha, MD,
Yang-Bum Cho, MD,
Byung-Dam Ryu, MD and
Irvin Oh, MD
Investigation performed at the Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
Seung-Ho Kim, MD
Byung-Dam Ryu, MD
Irvin Oh, MD
Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea . E-mail address for S.-H. Kim: smcknot{at}hotmail.com
Kwon-Ick Ha, MD
Department of Orthopaedic Surgery, Seoul Veterans Hospital, 6-2 Dunchon-Don, Kangdong-Ju, Seoul 134-791, Korea
Yang-Bum Cho, MD
Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital Hanlym University, 948-1 Daelim Dong, Yongdungpo-Ku, Seoul 150-071, Korea
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Background: The purpose of this study was to evaluate prospectively the surgical outcomes of arthroscopic repair of anterior capsulolabral lesions with use of suture anchors in a large series of patients who were followed for two to six years.
Methods: We evaluated the results of arthroscopic Bankart repair with use of suture anchors and nonabsorbable sutures in 167 patients with traumatic recurrent anterior instability of the shoulder. The mean age at the time of the operation was twenty-five years. Preoperatively and at the time of follow-up (at a mean of forty-four months), the patients were assessed with three objective outcome measurement tools (the Rowe score, the University of California at Los Angeles [UCLA] shoulder rating scale, and the American Shoulder and Elbow Surgeons [ASES] score) and two subjective measurement tools (pain and function visual analog scales). The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated.
Results: All shoulder scores improved after surgery (p < 0.001). According to the Rowe scale, 130 patients (78%) had an excellent score; twenty-nine (17%), a good score; six (4%), a fair score; and two (1%), a poor score. Overall, the rate of postoperative recurrence of instability was 4% (one dislocation, two subluxations, and four positive results on the anterior apprehension test). Postoperative recurrence was related to an osseous defect of >30% of the entire glenoid circumference. In the patients with recurrent postoperative instability, the episodes were less frequent than they had been preoperatively and shoulder function was related to activity level. A revision arthroscopic Bankart repair stabilized three of the four shoulders in which it was performed. One hundred and fifty-two patients (91%) returned to  90% of their preinjury activity level. The mean loss of external rotation (and standard deviation) was 2.0° ± 4.0°.
Conclusions: We found that, in contrast to previous reports on the results of arthroscopic repair, arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.
Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
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