Authors: Omar Boughebri Ali Maqdes Constantina Moraiti Choukry Dib Franck Marie Leclère Philippe Valenti
Publish Date: 2014/12/06
Volume: 25, Issue: 4, Pages: 709-716
Abstract
The Instability Severity Index Score ISIS includes preoperative clinical and radiological risk factors to select patients who can benefit from an arthroscopic Bankart procedure with a low rate of recurrence Patients who underwent an arthroscopic Bankart for anterior shoulder instability with an ISIS lower than or equal to four were assessed after a minimum of 5year followupFortyfive shoulders were assessed at a mean of 79 months range 60–118 months Average age was 294 years range 17–58 years at the time of surgery Postoperative functions were assessed by the Walch and Duplay and the Rowe scores for 26 patients an adapted telephonic interview was performed for the 19 remaining patients who could not be reassessed clinically A failure was defined by the recurrence of an anterior dislocation or subluxation Patients were asked whether they were finally very satisfied satisfied or unhappyThe mean Walch and Duplay score at last followup was 843 range 35–100 The final result for these patients was excellent in 14 patients 538 good in seven cases 269 poor in three patients 115 and bad in two patients 77 The mean Rowe score was 826 range 35–100 Thirtynine patients 867 were subjectively very satisfied or satisfied and six 133 were unhappy Four patients 89 had a recurrence of frank dislocation with a mean delay of 34 months range 12–72 months Three of them had a Hill–Sachs lesion preoperatively Two patients had a preoperative ISIS at 4 points and two patients at 3 pointsThe selection based on the ISIS allows a low rate of failure after an average term of 5 years Lowering the limit for indication to 3 points allows to avoid the association between two major risk factors for recurrence which are valued at 2 points The existence of a Hill–Sachs lesion is a stronger indicator for the outcome of instability repairNo financial remuneration related directly or indirectly to the subject of the article has been received by the authors or by any member of their family Each author certifies that he or she has no commercial associations eg consultancies stock ownership equity interest and patent/licensing arrangements that might pose a conflict of interest in connection with the submitted article
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