Developments in Bankart repair for treatment of anterior instability of the shoulder.

In the past 10 years, Bankart repair for operative treatment of recurrent luxation of the shoulder has become well established. Recently, the arthroscopic Bankart procedure has been developed. Since 1991, cannulated, bioabsorbable plugs are being used (Suretac; Acufex Microsurgical, Mansfield, Ma., USA). This investigation examines what the advantages of this micro-invasive technique are compared with the open Bankart procedure. From 1986 to 1995, 120 patients underwent Bankart repair of the shoulder in our hospital. Since 1993 we have preferred using arthroscopy, and since 1994 with Suretac. We were able to follow-up 93 patients. The results were assessed using the criteria of stability, range of motion, pain and functional results. The patients were evaluated using the Rowe score. The mean follow-up time was much shorter in the arthroscopic group. Nevertheless, we registered a higher reluxation rate (2 patients, 8%) in comparison with the group that underwent open surgery (3 patients, 4%). As postoperative pain and deterioration of range of motion are less, however, the mean Rowe score shows no significant difference. In conclusion, proper selection of patients has to be performed: arthroscopic Bankart repair is recommended for refixation of a detached anterior labrum. It is disadvantageous when the labrum is degenerated or the capsular tissue is attenuated. That is why, in our opinion, the open Bankart procedure with its capsulorrhaphy cannot be renounced completely.