Clinical Outcomes, Return to Sport and Psychological Readiness After Arthroscopic Bankart Repair Using Knotless All-Suture Anchors at a Minimum 2Year Follow-up.

PURPOSE: To report the clinical outcomes, return to sport (RTS) and psychological readiness of patients who underwent arthroscopic Bankart repair with knotless all-suture anchors with a minimum follow-up of 2 years.

METHODS

In this retrospective case series, consecutive patients who underwent primary arthroscopic Bankart repair using knotless all-suture anchors between 08/2019 and 07/2022 were included. Patient-reported outcomes were assessed using the Western Ontario Shoulder Instability Index (WOSI), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), Shoulder Instability-Return to Sport after Injury (SI-RSI) scale, subjective shoulder value (SSV), and the visual analogue scale (VAS) for pain. Patient satisfaction, RTS, return to preinjury level of sport, instability recurrence and revisions were recorded. Receiver operating characteristic (ROC) curve was calculated to assess the discriminative performance of the SI-RSI scale, and the Youden's index was employed to determine the optimal cutoff for prediction of return to preoperative level of sports.

RESULTS

Of 57 patients eligible for inclusion, 46 patients (11.1% female, 28.7 ± 6.8 years at surgery) were available at a follow-up of 2.9 [2.3-3.4] years. Three patients (6.5%) reported a redislocation, one patient (2.2%) underwent a revision and was excluded from analysis. At final follow-up, an ASES score of 98 (92-100), a DASH score of 2.5 (0-6.7), a WOSI of 11 (3.3-18), an SSV of 93 (85-97) along with low levels of pain were reported. A total of 43 (97.7%) of patients reporting preoperative activity (n = 44) achieved RTS, with 20 patients (45.5%) who had returned to preoperative level of sports. Patients achieving return to preoperative level of sports had a significantly higher SI-RSI scale (89 [83-94]) than those who did not (61 [50-81], p < 0.001). The SI-RSI showed high discriminative performance for return to preoperative level of sports (area under ROC curve: 0.84 [95%CI 0.73-0.97]) with an optimal cutoff of 80 (Youden's index: 0.597).

CONCLUSION

At short-term follow-up, Bankart repair using knotless all-suture anchors demonstrated favorable patient-reported outcomes and low redislocation rates. Patients who did not return to their preinjury level of sport exhibited significantly lower psychological readiness. The SI-RSI exhibited high discriminative performance in predicting return to preoperative level of sports, with an optimal cutoff value of 80.

LEVEL OF EVIDENCE: IV - Retrospective case series.