Abstract
BACKGROUND: In recent years, on-track lesions have been subclassified as peripheral- and central-track lesions based on the Hill-Sachs lesion occupancy within the glenoid track. Studies have stated that arthroscopic Bankart repair can be performed in noncontact athletes with on-track lesions, regardless of whether they are classified as peripheral or central track. However, this assumption currently remains theoretical and requires confirmation or refutation through clinical follow-up studies. PURPOSE/HYPOTHESIS: The purpose of this study is to evaluate the effect of peripheral- and central-track lesions on long-term clinical outcomes in a homogeneous cohort of noncontact athletes undergoing arthroscopic Bankart repair. It was hypothesized that arthroscopic Bankart repair provides satisfactory long-term outcomes for both central-track and peripheral-track lesions in noncontact athletes. STUDY DESIGN: Retrospective cohort study; Level of evidence, 3. METHODS: Patients who underwent arthroscopic Bankart repair for shoulder instability from 2013 to 2017 were retrospectively evaluated. Patients with a glenoid defect <25%, on-track lesions, and participation in noncontact sports were included in the study. Patients were classified as having peripheral-track lesions (lesion in the medial one-fourth of the glenoid track) and central-track lesions (lesion in the lateral three-fourths of the glenoid track). The 2 groups were compared in terms of demographic characteristics, redislocation rates, return to sports, and patient-reported outcome measures, including the American Shoulder and Elbow Surgeons, Western Ontario Shoulder Instability Index, and visual analog scale scoring systems. RESULTS: The study included 101 patients: 62 with central-track lesions (mean ± SD; age, 26.6 ± 8.7 years; follow-up, 9.1 ± 1.2 years) and 39 with peripheral-track lesions (mean ± SD; age, 25.9 ± 6.9 years; follow-up, 8.8 ± 1.2 years). At the final follow-up, no significant differences were observed between the 2 groups for Western Ontario Shoulder Instability Index (P = .162), American Shoulder and Elbow Surgeons (P = .524), or visual analog scale (P = .754) scoring systems. Additionally, redislocation rates and return-to-sport proportions were similar between both groups, with rates of 13% and 15% for redislocation (P = .471) and 82% and 80% for return to sports (P = .461), respectively. CONCLUSION: In patients with shoulder instability who participate in noncontact sports and have on-track lesions, arthroscopic Bankart repair provides satisfactory long-term clinical outcomes regardless of whether the lesion is classified as peripheral track or central track.