Long-term results with the Bankart and Bristow-Latarjet procedures: recurrent shoulder instability and arthropathy.

摘要

We retrospectively analyzed 26 shoulders in 24 patients 16 to 20 years (mean, 17.5 years) after a Bankart repair and compared these with a prospective series of 30 shoulders in 28 patients 15 years (mean, 15.1 years) after a Bristow-Latarjet repair for recurrent anterior dislocation of the shoulder. At follow-up one patient in each group had undergone revision surgery for recurrent instability. Two patients in the Bankart group had spontaneous stabilization of postoperative instability. Further, one patient in this group had had one subluxation during the follow-up period. In the Bristow group one patient reported 3 recurrences 3 years postoperatively. This patient has had no further redislocations during the past 12 years. Subluxations occurred occasionally several times in 2 patients in the Bristow group, but these patients were satisfied with the procedures at follow-up. No patient in the Bankart group had apprehension at follow-up. Eight patients in the Bristow group had subjective and/or objective apprehension. Throwing ability after surgery in the dominant shoulder was considered normal in 8 of 12 patients in the Bristow series and in 1 of 11 patients in the Bankart series. In the Bankart group 17 patients were "very satisfied" with the operative result, 7 were "satisfied," and 1 was "dissatisfied." The corresponding figures for the Bristow group were 24 who were very satisfied and 5 who were satisfied. Dislocation arthropathy was found in 16 of 26 Bankart shoulders (14 mild and 2 moderate) and in 9 of 30 Bristow shoulders (5 mild, 3 moderate, and 1 severe). The Bankart procedure seemed to be more successful than the Bristow-Latarjet repair when stability at follow-up was considered. However, when other criteria, as well as the patients' assessment of the operative result, are included, both methods can be recommended without any major differences.