Long‐Term Clinical Outcomes of Arthroscopic Suture Anchor Fixation of Bony Bankart Lesions at a Mean 18‐Year Follow‐Up

Purpose To evaluate shoulder stability and function at long‐term follow‐up after arthroscopic single‐row suture anchor fixation of bony Bankart lesions. Methods This was a retrospective, single‐center study. Patients with anterior glenoid rim fractures after traumatic shoulder instability who underwent arthroscopic single‐row suture anchor fixation for bony Bankart lesions between 1999 and 2010 were included. Only patients with a minimum follow‐up of 14 years were eligible for the present long‐term analysis. Patients completed a standardized questionnaire including clinical data regarding shoulder stability, reoperation, patient satisfaction, and sports activity as well as patient‐reported outcome measures, including the Constant Score, Subjective Shoulder Value (SSV), American Shoulder and Elbow Surgeons Score, Oxford Instability Score, and Western Ontario Shoulder Instability Index. Changes in patient‐reported outcome measures were evaluated using cohort‐specific minimal clinically important difference thresholds, and patient satisfaction was assessed against a predefined threshold (≥8/10). Paired t‐tests or Wilcoxon signed‐rank tests were used as appropriate, with P   Results Fifty patients were initially identified, of whom 45 were included in a previously published midterm follow‐up study. Of these, 13 patients were unavailable for long‐term follow‐up (7 lost to follow‐up and 6 deceased), resulting in a final cohort of 32 patients with a mean follow‐up of 18.3 years (range, 14.4‐25.1 years). Of patients, 90.6% reported no subjective instability. The redislocation rate was 3.1% (1 patient), and the recurrent subjective instability rate was 9.4% (3 patients). Two patients required revision surgery (1 open reosteosynthesis after traumatic glenoid fracture 9 years postoperatively and 1 reverse shoulder arthroplasty because of cuff arthropathy 21.9 years postoperatively). High satisfaction was reported by 29 of 32 patients (90.6%) based on the predefined threshold, and 96.9% of patients indicated that they would undergo the procedure again. Most patients (92.9%) returned to sports at the same level or higher than compared with their preinjury level. The mean Constant Score was 80.7 points, SSV 87.2%, American Shoulder and Elbow Surgeons 92.4 points, Oxford Instability Score 44.6 points, and Western Ontario Shoulder Instability Index 90.4 points. Although a statistically significant decline in SSV was observed over time ( P   Conclusions Arthroscopic single‐row suture anchor repair of bony Bankart lesions provides excellent long‐term stability with low rates of recurrence and reoperation, high patient satisfaction, and favorable functional outcomes, even after nearly 2 decades. Level of Evidence Level IV, retrospective case series.