Early Surgical Stabilization Is a Positive Predictor Whereas Dominant Extremity Involvement and Off-Track Lesions Are Negative Predictors in Arthroscopic Repair of Bony Bankart Lesions With Glenoid Bone Loss <25.

Abstract

To evaluate the minimal clinically important difference (MCID), significant clinical benefit (SCB), and patient acceptable symptomatic status (PASS) in patients who underwent arthroscopic repair of bony Bankart lesions and to analyze the effect of patient characteristics on these parameters. This retrospective case series included patients who underwent shoulder arthroscopy for bony Bankart lesions by a single surgeon between 2015 and 2022. Inclusion criteria were patients with <25% glenoid bone defect and a minimum follow-up of 24 months. Assessment included Rowe, American Shoulder and Elbow Surgeons (ASES), SANE (Single Assessment Numeric Evaluation), and visual analog scale (VAS) scores. Patients who met the MCID, SCB, and PASS thresholds for Rowe, ASES, SANE, and VAS were determined. Regression analysis was used to determine the factors affecting thresholds achievement. A total of 76 patients (mean age 32.2 ± 12.3 years; mean follow-up 57.5 ± 25.4) were included in the study. MCID, PASS, and SCB thresholds were calculated, respectively, for Rowe (9.9, 77.5, 32.5), ASES (9.7, 76.5, 36.5), SANE (11, 82.5, 27.5), and VAS (1.04, 3.5, 5.5). The rates of patients achieving MCID, PASS, and SCB were determined, respectively, Rowe (97%, 84%, 80%), ASES (98%, 79%, 71%), SANE (94%, 77%, 72%), and VAS (96%, 83%, 74%). Increased odds of achieving PASS and SCB were associated with early presentation. Reduced odds of achieving PASS and SCB were associated with dominant extremity involvement and off-track lesions. The current study revealed that early surgical stabilization was a positive predictor for achieving clinically significant outcomes, whereas dominant extremity involvement and off-track lesions were negative predictors. Level IV, therapeutic study, retrospective case series.