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The Bankart procedure
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1978
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Hill-sachs LesionSurgeryOrthopaedic SurgerySport InjuryRetail BankingKinesiologyShoulder MotionOrthopaedicsBankart ProcedureHealth SciencesMedicineLoansAnterior Glenoid RimShoulder SurgeryPhysical TherapyAthletic TrainingRotator CuffShoulder GirdleBankruptcy
In shoulder instability surgery, the most common intra‑operative lesions are capsule separation from the anterior glenoid rim (85 %), Hill‑Sachs humeral head lesions (77 %), and anterior glenoid rim damage (73 %). The study followed 161 patients (162 shoulders) operated between 1946 and 1976, with 124 re‑examined and 21 completing a questionnaire. The meticulous Bankart repair yielded a 3.5 % recurrence rate, 97 % of patients rated their outcome as excellent or good, 69 % retained full range of motion, only 2 % redislocated, and most returned to competitive sport, with rim fractures not increasing recurrence and only a slight risk increase from moderate‑to‑severe Hill‑Sachs lesions.
Of 161 patients with 162 shoulders operated on during a thirty-year period (1946 to 1976), 124 were re-examined and twenty-one answered a questionnaire. The lesions found at surgery were separation of the capsule from the anterior glenoid rim in 85 per cent, a Hill-Sachs lesion of the humeral head in 77 per cent, and damage to the anterior glenoid rim (including fracture) in 73 per cent. There were five recurrences (3.5 per cent) after repair by the method described in the 145 shoulders that were followed. Only one of the forty-six patients with dislocation on the dominant side and one of the thirty-one with dislocation on the non-dominant side failed to return to the competitive athletic activities in which they participated prior to injury. The results at follow-up were rated excellent in 74 per cent, good in 23 per cent, and poor in 3 per cent. Ninety-eight per cent of the patients rated their result as excellent or good. Sixty-nine per cent of the shoulders had a full range of motion, and only 2 per cent of these shoulders redislocated. A fracture of the rim of the glenoid did not increase the risk of recurrence, while a moderate to severe Hill-Sachs lesion increased the risk only slightly. We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.