Risk factors for recurrent shoulder dislocation after arthroscopic Bankart repair: The role of age, lesion type, and middle glenohumeral ligament variations.

Abstract

Objectives: The aim of this study was to evaluate the effect of patient characteristics, including middle glenohumeral ligament (MGHL) morphological types, on the risk of redislocation following arthroscopic labral repair.

Patients and methods: Between February 2018 and May 2020, a total of 138 patients (105 males, 33 females; mean age: 26.5±9.8 years; range, 13 to 65 years) who underwent arthroscopic Bankart repair for traumatic anterior shoulder instability were retrospectively analyzed. Demographic data, the presence of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, and information regarding the morphology of the MGHL were collected. Clinical outcomes were assessed using the Oxford Shoulder Instability Score (OSIS) and the Visual Analog Scale (VAS). The morphology of MGHL was classified through the analysis of surgical video recordings.

Results: Among the patients, ALPSA lesions were observed in 40% of cases. Redislocation occurred in 18% of patients and was significantly associated with younger age and ALPSA lesions. Multivariate logistic regression revealed that younger age at the time of surgery (odds ratio [OR]=0.936, p=0.047) and the presence of ALPSA lesions (OR=2.953, p=0.027) were independent predictors of redislocation. The morphology of MGHL showed no significant association with recurrence. The OSIS and VAS scores improved significantly postoperatively (p<0.001), and stable patients had more favorable final patient-reported outcome measures compared to those with redislocation.

Conclusion: Although variations in MGHL morphology did not independently influence outcomes, younger age and presence of ALPSA lesions were identified as predictors of postoperative instability following arthroscopic Bankart repair. Based on these findings, the increased risk of redislocation in younger patients and those with ALPSA lesions should be carefully considered during treatment planning.