The Influence of Exposure in Training to the Open Bankart on the Declining Current Use of the Procedure.

OBJECTIVE

The purpose of this study was to assess the influence of exposure to the open Bankart during residency and fellowship on the trend toward obsolescence of the procedure. Our hypothesis was that the open Bankart would be used with decreasing frequency and that this would be related to lack of exposure to the procedure during training.

METHODS

A survey consisting of 10 questions about their experience with the open Bankart procedure in residency, fellowship, and practice, as well as their current usage of it and other operations, was sent to members of the American Shoulder and Elbow Surgeons. Respondents were divided into groups based on the year of completion of training.

RESULTS

Statistical analysis of the responses revealed a notable trend of progressively diminished use of the open Bankart by those trained before 2000 compared with those completing training between 2001 and 2017. Ancillary findings included more surgeons using the open Bankart for revision cases than as a primary procedure and many using the Latarjet for patients with less than 15% or even no glenoid bone loss.

CONCLUSION

We concluded that a statistically notable trend of the decreasing use of the open Bankart was observed despite excellent reported outcomes and that its current role is most likely as a revision procedure. Lack of exposure to the operation in training is a major factor in its decline, and this decreasing exposure is self-perpetuating.

LEVEL OF EVIDENCE: Survey.