A study on Subscapularis augmented Bankart repair (SB) vs capsulo-labral Bankart repair (CB) for recurrent anterior shoulder dislocation with moderate glenoid bone loss (< 20 %) in non-athlete population

Introduction-Subscapularis augmented Bankart repair (SB) is a novel arthroscopic technique of tenodesis of upper 1/3rd fibers of subscapularis tendon to capsulo-labral repair of Bankart lesion. Treatment of Bony Bankart lesion with glenoid bone loss % (GBL%) 10%-20 % is still a grey zone where bone augmentation procedures are an overtreatment and capsulo-labral repair is associated with high recurrence.Methodology: A retrospective study of 30 patients with h/o anterior instability with GBL%<20 % were classified into two groups. SB group included patients managed with arthroscopic subscapularis augmentation while CB group included patients managed with arthroscopic capsulo-labral repair. These patients were followed up after a minimum of 24 months post-surgery and functional outcomes evaluated using WOSI, ASES and ROWE scores.Results: Patients in the SB group showed superior functional outcomes for WOSI and ROWE scores. Considering postoperative shoulder pain, the median ROWE-P (pain) score was better for SB group (10/10) when compared to CB group (5/10). Patients under SB group were more comfortable with physical symptoms of their shoulder (WOSI-P average 60/1000) and were more likely to continue their recreational sports activity (WOSI-sports for SB 63.7 and CB 119.5. In our study, none of the 15 SB patients had any restriction in range of shoulder movements [ROWE-M score of 10]. Subscapularis augmented Bankart repair is associated with minimal restriction of shoulder range, better pain relief, better acceptability and smoother return to daily living and occupation and can be considered as a routine for every patient with GBL<20 %.