Postoperative Management Following Arthroscopic Bankart Repair in Adolescents and Young Adults: A Systematic Review

Overview

Journal Arthrosc Sports Med Rehabil

Date 2020 Dec 28

PMID 33364615

Citations 2

Authors

Katie Kim

Michael G Saper

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to review systematically the literature concerning postoperative management following arthroscopic Bankart repair for traumatic anterior shoulder instability in adolescent and young adult (≤ 25 years) athletes.

Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL), and Google Scholar databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting postoperative rehabilitation guidelines following arthroscopic Bankart repair in the adolescent and young adult population. The Methodological Index for Nonrandomized Studies instrument and Modified Coleman Methodology Score were used for quality assessment of the included studies. All aspects of rehabilitation were extracted and analyzed, including type/duration of immobilization, range of motion, strength, and return to sport (RTS) criteria.

Results: Screening yielded 17 eligible studies with a total of 675 patients and an average age of 18.3 years. There was considerable variation with regard to reported postoperative rehabilitation guidelines. Of the 17 studies, 15 reported the duration of immobilization; there was a mean of 4 weeks (range, 2-6 weeks). Range of motion and strength restrictions were reported in 15 (88.2%) and 13 (76.4%) studies, respectively. All of the 17 studies included an expected timeframe for RTS, but only 5 of the studies (29.4%) included either subjective or objective criteria to determine safe RTS. Differences in outcomes were unable to be assessed due to large study heterogeneity.

Conclusion: Considerable variation is reported in postoperative rehabilitation guidelines following arthroscopic Bankart repair for traumatic shoulder instability in the adolescent and young adult population. All studies used time-based criteria for determining RTS, but subjective and/or objective criteria were lacking in the majority of studies. The current literature lacks data to generate evidence-based rehabilitation protocols in this young athletic population.

Level Of Evidence: Level IV, systematic review of Level II-IV studies.

Citing Articles

Rehabilitation Protocol Variability Following Arthroscopic Bankart Repair and Remplissage for Management of Anterior Shoulder Instability: A Systematic Review.

Villarreal-Espinosa J, Reinold M, Khak M, Shariyate M, Mita C, Kay J Int J Sports Phys Ther. 2024; 19(10):1172-1187.

PMID: 39371186 PMC: 11446737. DOI: 10.26603/001c.123481.

Factors That Influence the Return to Sport After Arthroscopic Bankart Repair for Glenohumeral Instability.

Rossi L, Pasqualini I, Tanoira I, Ranalletta M Open Access J Sports Med. 2022; 13:35-40.

PMID: 35401017 PMC: 8985826. DOI: 10.2147/OAJSM.S340699.

References

Jones K, Wiesel B, Ganley T, Wells L . Functional outcomes of early arthroscopic bankart repair in adolescents aged 11 to 18 years. J Pediatr Orthop. 2007; 27(2):209-13. DOI: 10.1097/bpo.0b013e31803173d6. View

Kim S, Ha K, Jung M, Lim M, Kim Y, Park J . Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: a prospective randomized clinical study. Arthroscopy. 2003; 19(7):722-31. DOI: 10.1016/s0749-8063(03)00397-9. View

OCONNELL P, Nuber G, Mileski R, Lautenschlager E . The contribution of the glenohumeral ligaments to anterior stability of the shoulder joint. Am J Sports Med. 1990; 18(6):579-84. DOI: 10.1177/036354659001800604. View

Kasik C, Rosen M, Saper M, Zondervan R . High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: a systematic review. J ISAKOS. 2019; 4(1):33-40. PMC: 6487304. DOI: 10.1136/jisakos-2018-000224. View

De Carli A, Pasquale Vadala A, Lanzetti R, Lupariello D, Gaj E, Ottaviani G . Early surgical treatment of first-time anterior glenohumeral dislocation in a young, active population is superior to conservative management at long-term follow-up. Int Orthop. 2019; 43(12):2799-2805. DOI: 10.1007/s00264-019-04382-2. View

Rugg C, Hettrich C, Ortiz S, Wolf B, Zhang A . Surgical stabilization for first-time shoulder dislocators: a multicenter analysis. J Shoulder Elbow Surg. 2018; 27(4):674-685. DOI: 10.1016/j.jse.2017.10.041. View

Tjong V, Devitt B, Murnaghan M, Ogilvie-Harris D, Theodoropoulos J . A Qualitative Investigation of Return to Sport After Arthroscopic Bankart Repair: Beyond Stability. Am J Sports Med. 2015; 43(8):2005-11. DOI: 10.1177/0363546515590222. View

Gaunt B, Shaffer M, Sauers E, Michener L, McCluskey G, Thigpen C . The American Society of Shoulder and Elbow Therapists' consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. J Orthop Sports Phys Ther. 2010; 40(3):155-68. DOI: 10.2519/jospt.2010.3186. View

Chapus V, Rochcongar G, Pineau V, Salle de Chou E, Hulet C . Ten-year follow-up of acute arthroscopic Bankart repair for initial anterior shoulder dislocation in young patients. Orthop Traumatol Surg Res. 2015; 101(8):889-93. DOI: 10.1016/j.otsr.2015.09.029. View

10.

Podlog L, Eklund R . Returning to competition after a serious injury: the role of self-determination. J Sports Sci. 2010; 28(8):819-31. DOI: 10.1080/02640411003792729. View

11.

Torrance E, Clarke C, Monga P, Funk L, Walton M . Recurrence After Arthroscopic Labral Repair for Traumatic Anterior Instability in Adolescent Rugby and Contact Athletes. Am J Sports Med. 2018; 46(12):2969-2974. DOI: 10.1177/0363546518794673. View

12.

Gigis I, Heikenfeld R, Kapinas A, Listringhaus R, Godolias G . Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents. J Pediatr Orthop. 2013; 34(4):421-5. DOI: 10.1097/BPO.0000000000000108. View

13.

Law B, Yung P, Ho E, Chang J, Chan K . The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients. Knee Surg Sports Traumatol Arthrosc. 2007; 16(2):188-93. DOI: 10.1007/s00167-007-0453-2. View

14.

Hughes J, Bastrom T, Pennock A, Edmonds E . Arthroscopic Bankart Repairs With and Without Remplissage in Recurrent Adolescent Anterior Shoulder Instability With Hill-Sachs Deformity. Orthop J Sports Med. 2018; 6(12):2325967118813981. PMC: 6295689. DOI: 10.1177/2325967118813981. View

15.

Nixon M, Keenan O, Funk L . High recurrence of instability in adolescents playing contact sports after arthroscopic shoulder stabilization. J Pediatr Orthop B. 2015; 24(3):173-7. DOI: 10.1097/BPB.0000000000000135. View

16.

Booth F . Physiologic and biochemical effects of immobilization on muscle. Clin Orthop Relat Res. 1987; (219):15-20. View

17.

Rahu M, Kartus J, Poldoja E, Pedak K, Kolts I, Kask K . Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?. Orthop J Sports Med. 2018; 6(6):2325967118781311. PMC: 6077916. DOI: 10.1177/2325967118781311. View

18.

Coleman B, Khan K, Maffulli N, Cook J, Wark J . Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000; 10(1):2-11. DOI: 10.1034/j.1600-0838.2000.010001002.x. View

19.

Robinson C, Howes J, Murdoch H, Will E, Graham C . Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am. 2006; 88(11):2326-36. DOI: 10.2106/JBJS.E.01327. View

20.

Yagmur Ozturk B, Maak T, Fabricant P, Altchek D, Williams R, Warren R . Return to sports after arthroscopic anterior stabilization in patients aged younger than 25 years. Arthroscopy. 2013; 29(12):1922-31. DOI: 10.1016/j.arthro.2013.09.008. View