Prospective evaluation of arthroscopic Bankart repair for recurrent anterior shoulder instability: functional outcomes, complications, and risk factors

Arthroscopic Bankart repair is widely used for recurrent anterior shoulder instability; however, prospective data on clinical outcomes and failure patterns remain limited, particularly in underrepresented populations. The aim of this study was to prospectively evaluate functional outcomes, complications, and treatment failure following arthroscopic Bankart repair, and to explore potential risk factors for failure. Patients with glenoid bone loss greater than 25% on preoperative three-dimensional computed tomography were excluded. Glenoid bone loss was quantified using the best-fit circle method, and concomitant Hill–Sachs lesions were systematically documented. Functional outcomes were assessed using range of motion, Visual Analog Scale (VAS), Constant–Murley score, University of California Los Angeles (UCLA) score, and Oxford Shoulder Instability score. Postoperative complications and treatment failure were recorded. Treatment failure was categorized as technical failure (intraoperative anchor fixation failure) or clinical failure (postoperative instability requiring revision surgery). This prospective cohort study included 72 consecutive patients undergoing arthroscopic Bankart repair for recurrent anterior shoulder instability. Patients were followed for a minimum of 24 months with no loss to follow-up. Glenoid bone loss was less than 10% in 61 patients (84.7%), and Hill–Sachs lesions were identified in 61 patients (84.7%). Significant improvements were observed in all functional outcome measures at final follow-up ( p < 0.001). No cases of complete redislocation were recorded. The overall failure rate was 5.6% ( n = 4), including technical failure ( n = 2) and clinical failure ( n = 2). Postoperative complications excluding failure were infrequent and manageable. Exploratory univariable analyses did not identify a statistically significant predictor of postoperative complications; the estimates were imprecise because of the small number of events and sparse subgroup data. The small number of treatment failures precluded a reliable analysis of predictors of treatment failure. At 24 months, arthroscopic Bankart repair was associated with improved functional outcomes in appropriately selected patients. Two patients developed recurrent symptomatic instability requiring revision surgery, although no complete postoperative redislocation was documented. The small number of complications and treatment failures precluded definitive risk-factor analysis. Larger, adequately powered studies with longer follow-up are required to identify predictors of complications, recurrence, and treatment failure.