Investigation of prognostic factors affecting clinical and functional outcomes in patients undergoing arthroscopic bankart repair

Introduction and objectives: Glenohumeral joint is a ball-socket type joint in which stability is provided by soft tissues rather than bone. While this makes it the joint with the most joint space, it also makes it the joint where joint dislocations are most common. In this study, we aimed to identify and evaluate prognostic factors affecting the clinical and functional outcomes of patients with Bankart lesions due to recurrent shoulder dislocation who underwent arthroscopic repair. Method: 80 patients who met our study criteria and underwent arthroscopic bankart repair at İnönü University Turgut Özal Medical Center between January 1, 2012 and January 1, 2023 were called for control. A direct radiograph was taken and the current condition of the shoulder was evaluated. The patients' joint range of motion, apprehension test and general shoulder examination were examined. The patients' current Rowe constant wosi, vas and qdash scores were checked. The occupation of the patients, the sports they played, whether the dislocation occurred again after the surgery, how long after the surgery, the time to return to work after the surgery, the number of dislocations before the surgery, the age of the first dislocation, and which side the dislocation was on were questioned and evaluated. By examining the files in the archives, surgery videos and surgery notes of these patients, preoperative shoulder scores, preoperative hill-shacks size in preoperative CT, glenoid defect rate, whether the lesion is off-track or not, number of anchors used, preoperative joint range of motion, age at which the patients were operated on and preoperative scores were determined. . Statistical analysis of these parameters was performed. Results: 80 patients with anterior instability were included in our study. The average age of the patients was 32.4 (min: 20-max: 57). 68 (82%) of the patients were male and 12 (18%) were female. While 55 of the patients had a dislocation on their dominant side, 25 of them had a dislocation on their non-dominant side. The average age of the patients at surgery was 26.7 (17-49). On average, 50 (9-216) months elapsed between the patients' first dislocation and surgery. The average follow-up period of the patients was calculated as 66 (12-132) months. On average, 2.6 (2-4) knotless anchors were used in the patients. The average number of dislocations reported by the patients before surgery was calculated as 22 (1-100). Re-dislocation developed in 19 of the patients. In these patients, dislocation developed again after an average of 7 (3-24) months. The average age of the patients at their first dislocation was calculated as 23.3 (14-48) years. Patients returned to work on average 6.4 (3-24) months after surgery. Conclusion: In this study, the difference between the preoperative and postoperative averages of all the scores we looked at to evaluate the patients was significant. Therefore, it can be said that arthroscopic Bankart repair is a treatment method with satisfactory clinical results and a low complication rate in patients with Bankart lesion after recurrent shoulder dislocation. In this study, when we compared patients with and without redislocation, the difference in the means of all scores between the two groups was significant. In patients with re-dislocation after surgery, the follow-up period was longer, the number of dislocations before surgery was higher, and the amount of glenoid defect on pre-surgical CT was greater, and these variables were statistically significant.