Long-Term Outcomes following Instability After Isolated Arthroscopic Bankart Repair for On-Track Hill-Sachs Lesions With <20% Glenoid Bone Loss

Background: Recurrent anterior shoulder instability rates are high after isolated arthroscopic Bankart repair (ABR), especially among patients with off-track Hill-Sachs lesions (HSLs) and significant glenoid bone loss. However, there are limited data on long-term recurrent anterior shoulder instability rates and patient-reported outcomes (PROs) following isolated ABR among patients with on-track HSLs and <20% glenoid bone loss. Purpose: To evaluate long-term clinical outcomes and PROs after isolated ABR for on-track HSLs with <20% glenoid bone loss, a population where isolated ABR remains indicated. Study Design: Case-control study; Level of evidence, 3. Methods: < .05. Results: = .01). Conclusion: Rates of recurrent anterior shoulder instability were high following isolated ABR for on-track HSLs with <20% glenoid bone loss and were associated with inferior PROs at mean 10-year follow-up. Younger age and collision athletics were associated with sustaining recurrent anterior shoulder instability, while increased glenoid bone loss was an independent predictor of undergoing revision stabilization surgery. There remains a clinical need for improved stratification of on-track HSLs to identify patients who may benefit from additional procedures to improve recurrent anterior shoulder instability rates and subjective outcomes at long-term follow-up.