J Korean Fract Soc.  2007 Jan;20(1):53-57. 10.12671/jkfs.2007.20.1.53.

Result of Early Active Range of Motion Exercise after Bankart Repair of Traumatic Anterior Instability

• Noh HK
• Park JW
• Lee JI
• Park JH

• KMID: 2294379
• DOI: http://doi.org/10.12671/jkfs.2007.20.1.53

Abstract

PURPOSE
To evaluate prospectively the results of early active exercise after open Bankart repair of traumatic anterior shoulder instability.
MATERIALS AND METHODS
From January, 2001 to June, 2003, 26 patients who were followed up at least 1 year after open Bankart repair for traumatic anterior shoulder instability were evaluated. Average age was 23.9 years old (range, 19~43) with 24 males and 2 females. We evaluated them using the functional shoulder scores (modified Rowe score, ASES score), range of motion, VAS pain scale, patient's subjective satisfaction and return to unlimited daily living activity.
RESULTS
The shoulder functional scores increased significantly. At last follow up, the final range of motion were flexion in average 5° deficit in comparison to normal side, external rotation in average 10o deficit, and internal rotation in T9. The patient's subjective satisfaction was good in 2l patients (81%). Return to unlimited daily activity was possible in 23 patients (88.5%), and 19 patients (73%) rejoined to sports activity before injury. There were complications including anterior recurrent subluxation in 1 case, weakness of subscapularis muscle in 1 case.
CONCLUSION
In traumatic anterior shoulder instability, early active range of motion exercise after open Bankart repair does not decrease shoulder stability. Early exercise can be useful for returning to previous level of sports activity in young active patients.

Keyword

Shoulder; Traumatic anterior instability; Open Bankart repair; Early active exercise

MeSH Terms

Activities of Daily Living
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Range of Motion, Articular*
Shoulder
Sports

Figure

• 

  Fig. 1 The diagram shows the significant change of the functional shoulder score between preoperative and last follow-up period.

Reference

1. Altchek DW. Arthroscopic shoulder stabilization using a bioabsorbable fixation device. Instr Course Lect. 1996; 45:91–96.

2. Bacilla P, Field LD, Savoie FH 3rd. Arthroscopic Bankart repair in a high demand patient population. Arthroscopy. 1997; 13:51–60.

3. Berg EE, Ellison AE. The inside-out Bankart procedure . Am J Sports Med. 1990; 18:129–133.

4. Bigliani LU, Kurzweil PR, Schwartzbach CC, Wolfe IN, Flatow EL. Inferior capsular shift procedure for anterior-inferior shoulder instability in athletes. Am J Sports Med. 1994; 22:578–584.

5. Cole BJ, L'Insalata J, Irrgang J, Warner JJ. Comparison of arthroscopic and open anterior shoulder stabilization. A two to six-year follow-up study. J Bone Joint Surg Am. 2000; 82:1108–1114.

6. Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am. 2000; 82:991–1003.

7. Gill TJ, Zarins B. Open repairs for the treatment of anterior shoulder instability. Am J Sports Med. 2003; 31:142–153.

8. Green MR, Christensen KP. Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthroscopy. 1993; 9:371–374.

9. Hattrup SJ, Cofield RH, Weaver AL. Anterior shoulder reconstruction: prognostic variables. J Shoulder Elbow Surg. 2001; 10:508–513.

10. Hovelius L, Thorling J, Fredin H. Recurrent anterior dislocation of the shoulder. Results after the Bankart and Putti-Platt operations. J Bone Joint Surg Am. 1979; 61:566–569.

11. Jobe FW, Giangarra CE, Kvitne RS, Glousman RE. Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. Am J Sports Med. 1991; 19:428–434.

12. Kandziora F, Jager A, Bischof F, Herresthal J, Starker M, Mittlmeier T. Arthroscopic labrum refixation for post-traumatic anterior shoulder instability: suture anchor versus transglenoid fixation technique. Arthroscopy. 2000; 16:359–366.

13. Karlsson J, Magnusson L, Ejerhed L, Hultenheim I, Lundin O, Kartus J. Comparison of open and arthroscopic stabilization for recurrent shoulder dislocation in patients with a Bankart lesion. Am J Sports Med. 2001; 29:538–542.

14. Kartus J, Ejerhed L, Funck E, Kohler K, Sernert N, Karlsson J. Arthroscopic and open shoulder stabilization using absorbable implants. A clinical and radiographic comparison oftwo methods. Knee Surg Sports Traumatol Arthrosc. 1998; 6:181–188.

15. Kim SH, Ha KI, Jung MW, Lim MS, Kim YM, Park JH. Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: a prospective randomized clinical study. Arthroscopy. 2003; 19:722–731.

16. Lee KS, Seo JD, Oh KJ, Lee SJ, Wang SY. The result of modified bankart operation with suture anchor in traumatic recurrent anterior dislocation of shoulder joint. J Korean Soc Fract. 2001; 14:484–490.

17. Levine WN, Richmond JC, Donaldson WR. Use of the suture anchor in open Bankart reconstruction. A follow-up report. Am J Sports Med. 1994; 22:723–726.

18. Mair SD, Hawkins RJ. Open shoulder instability surgery. Complications. Clin Sports Med. 1999; 18:719–736.

19. Mizuno K, Nabeshima Y, Hirohata K. Analysis of Bankart lesion in the recurrent dislocation or subluxation of the shoulder. Clin Orthop Relat Res. 1993; 288:158–165.

20. Neer CS 2nd, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980; 62:897–908.

21. O Neill DB. Arthroscopic Bankart repair of anterior detachments of the glenoid labrum, A prospective study. J Bone Joint Surg Am. 1999; 81:1357–1366.

22. Rokito AS, Namkoong S, Zuckerman JD, Gallagher MA. Open surgical treatment of anterior glenohumeral instability: an historical perspective and review of the literature. Part I. Am J Orthop. 1998; 27:723–725.

23. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978; 60:1–16.

24. Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am. 1981; 63:863–872.

25. Sachs RA, Williams B, Stone ML, Paxton L, Kuney M. Open Bankart repair: correlation of results with postoperative subscapularis function. Am J Sports Med. 2005; 33:1458–1462.

26. Sohn SK, Kim BH, Kang DS. Operative treatment in the traumatic recurrent dislocation of the shoulder - a study of Bankart procedure -. J Korean Soc Fract. 1997; 10:242–249.

27. Wall MS, Warren RF. Complications of shoulder instability surgery. Clin Sports Med. 1995; 14:973–1000.

28. Youssef JA, Carr CF, Walther CE, Murphy JM. Arthroscopic Bankart suture repair for recurrent traumatic unidirectional anterior shoulder dislocations. Arthroscopy. 1995; 11:561–563.

29. Zarins B, McMahon MS, Rowe CR. Diagnosis and treatment of traumatic anterior instability of the shoulder. Clin Orthop Relat Res. 1993; 291:75–84.

30. Zarins B, Rowe CR, Stone JW. Shoulder instability: management of failed reconstructions. Instr Course Lect. 1989; 38:217–230.