van Blommestein, Matthijs (2020) Assessment of the value of the Instability Severity Index Score as a predictor for recurrence after the arthroscopic Bankart repair A retrospective cohort study in a large teaching hospital in the Netherlands. thesis, Medicine.
Full text available on request.Abstract
Introduction Anterior instability of the shoulder after dislocation often causes alterations to the anatomy, amongst which the Bankart lesion to the labrum. The Bankart lesion usually give rise to additional instability. There are multiple methods of treatment of this instability, including the arthroscopic Bankart repair, which has been topic of debate because there are high recurrence rates described. The Instability Severity Index Score (ISIS) was developed to assess the risk of recurrence instability after the arthroscopic Bankart repair, stating that a score higher than 6 is a contraindication for the Bankart repair since there is a 70% recurrence risk. This current study will assess the value of the ISIS in deciding whether the arthroscopic Bankart repair could be a valid treatment option. Methods This is a single-center retrospective cohort study assessing 149 shoulders, treated from 2014- 2019 with at least one year of follow-up. Patient and treatment characteristics were collected by searching the electronic patient files and a questionnaire was sent to all patients. Chi-squares, logistic regression and General Estimation Equations repeated measurement analyses were performed. Results The recurrence rate in this study was 18.1%. A significant correlation was identified between the ISIS and recurrence rate (p=0.028), however scores >6 did not have a significant correlation with recurrence (p=0.059). In the group ISIS >6 the recurrence rate was 30%. Discussion The ISIS does have a predictive value and should be assessed before performing the arthroscopic Bankart repair, it is however not absolute. With an increasing ISIS there is an increasing risk on recurrence. In this study with ISIS>6 there is a recurrence rate of 30%, and no significant correlation was identified. This study shows that shared decision making can be of use in deciding which surgery type is best suitable for patients with ISIS>6.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Govaert, Drs. L.H.M. and Verra, Dr. W. C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 21 Aug 2023 11:40 |
| Last Modified: | 21 Aug 2023 11:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3639 |
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