This study compared the long-term clinical results of an open Bankart procedure for anterior shoulder instability with those from an arthroscopic procedure, and evaluated the factors influencing the final outcomes and recurrence.

One hundred thirty three shoulders with a Bankart repair of a traumatic anterior shoulder instability with a follow-up period of at least 6 years were enrolled in this study. Sixty-seven shoulders had an open repair and sixty-six shoulders, an arthroscopic repair. The mean age at the time of the operation was 27.7 years (range, 17 to 62 years). The mean follow-up period was 100 months (range, 72 to 141 months).

At the last follow-up, the pain score during motion improved from 3.86 to 1.36. Forward flexion and external rotation at the side decreased to a mean of 3 °, 9 ° in the open group and a mean of 1 degree, 4 ° in the arthroscopic group. Sixty-two (93%) and 59 shoulders (89%) in the open and arthroscopic group could return to their pre-injury sports activities, respectively. At a mean 12.5 months after surgery, 14 shoulders (10.5%) experienced a redislocation. There were 6 (9%) and 8 (12%) redislocations in the open and arthroscopic groups, respectively.

The open group showed relatively better results than the arthroscopic group but there was no significant difference between two groups. Both open and arthroscopic Bankart procedures are effective methods that produce acceptable results when a precise surgical technique and proper postoperative rehabilitation are carried out.