Abstract
Twenty-one patients (21 shoulders) underwent open Bankart procedure using Neer’s reinforced capsular cruciate repair approach (modified open Bankart procedure) and received training. Postoperative changes in range of motion over time, and the status of ability to return to playing sports, were investigated. The average progress observation period was 12.8 months (range: 6 months to 2 years and 6 months). In the surgical procedure employed in this study, the capsule was reattached in the maximum external rotation position of the shoulder. Postoperative therapy consisted of flexion training, starting on postoperative day 5; external rotation (at the side) training, starting at postoperative week 2; and external rotation (in the abduction) training, starting at postoperative week 12. One patient experienced a postoperative subluxation. Results: The final range of motion was reached at 5 months in flexion, at 6 months in external rotation at the side and in the abduction, and at one year after surgery in internal rotation. The mean final range of motion was 168 degrees in flexion, 62.6 degrees in external rotation at the side, 93.8 degrees in external rotation in the abduction, and the seventh thoracic spinous process in internal rotation. The limitation of the range of motion, observed on the affected-side shoulder, was an average of 2 degrees in flexion, 7.5 degrees in external rotation at the side, and 9.5 degrees in external rotation in the abduction. Status of ability to return to sports: Preoperatively, 11 patients had played sports competitively, 9 recreationally, and one not at all. Postoperatively, one patient, who also had a knee ligament injury, shifted from competitive to recreational sports participation. Because of poor improvement in the range of internal rotation, it seems appropriate to also include internal rotation training as part of postoperative rehabilitation. It was also thought that external rotation training, in the abduction position of shoulder, should be started early, in order to improve external rotation in this position.
