My Arthroscopic Bankart Failed, Now What? Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization (2024 Annual Meeting)-My Arthroscopic Bankart Failed, Now What? Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization

My Arthroscopic Bankart Failed, Now What? Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization

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Video Summary

This ICL session, moderated by Albert Lin, features experts Dr. Dewan, Dr. Koiner, and Dr. Ivan Wong discussing management options for failed Bankart repairs in shoulder instability. Bankart repair is common but has high failure rates, especially in young, active patients or those with bone loss. Treatment varies based on factors such as bone loss, hyperlaxity, tissue quality, and patient activity.<br /><br />Revision options include arthroscopic Bankart repair (with or without remplissage), open Bankart repair, open Latarjet procedure, and bone grafting techniques like osteochondral allografts. Arthroscopic revision is popular due to lower complication rates and preservation of anatomy but may have higher recurrence in certain patients. Open Bankart repair suits patients with minimal bone loss and hyperlaxity and offers low recurrence but is less commonly practiced today. The Latarjet procedure is the gold standard for significant bone loss or off-track lesions, restoring stability via bone block and sling effects but carries higher complications and technical difficulty.<br /><br />Emerging alternatives include arthroscopic bone block procedures using distal tibial or distal clavicle grafts, offering potential advantages of less invasiveness, preservation of the subscapularis, and safer neurovascular profiles with comparable outcomes to Latarjet. However, graft resorption and long-term durability remain concerns.<br /><br />Case discussions highlighted challenges in measuring bone loss, assessing graft and anchor placement, and selecting the optimal revision strategy based on individual patient factors such as age, sport, and prior surgical technique. Experts emphasized meticulous preoperative evaluation, patient selection, and surgical technique.<br /><br />The panel underscored the importance of expanding beyond traditional comfort zones, adopting arthroscopic bone block techniques, and individualized treatment plans. They highlighted the need for continued advances in graft options, fixation methods, and surgeon training to optimize outcomes and reduce complications in revision shoulder instability surgery.

Asset Caption

Albert Lin, M.D., Moderator | Aman Dhawan, M.D. | Katherine J. Coyner, M.D. | Caroline M. Hettrich, M.D.

Keywords

Bankart repair

shoulder instability

revision surgery

arthroscopic Bankart repair

Latarjet procedure

bone grafting

remplissage

bone loss

hyperlaxity

arthroscopic bone block

surgical technique