Predictors of Failure of Arthroscopic Bankart Repair

Arthroscopic Bankart repair is increasingly used as the primary option for recurrent anterior shoulder instability. Improved techniques, technologies, and patient selection have resulted in high rates of success after these operations. Despite these improvements, failure is not uncommon, resulting in poor patient outcomes, increased rehabilitative time and costs, and athletic setbacks. Multiple factors may contribute to failure including the patient's anatomy, patient characteristics, and the surgeon's technical performance of the procedure. As many of these factors contribute to failure along a spectrum of risk, it is important for surgeons to optimize risks, limit technical errors, and choose alternative or adjunctive procedures where appropriate. In this article, we discuss the various risk factors associated with failure after arthroscopic Bankart repair, propose solutions and adjustments for modifiable risks, and provide considerations to take for nonmodifiable risk factors.