Publication:

Return to sport after arthroscopic Bankart repair in contact athletes: recurrence risk, surgical strategy and sport-specific considerations

Arthroscopic Bankart repair (ABR) is widely used for anterior shoulder instability, particularly in athletes. However, outcomes in contact athletes remain controversial due to higher functional demands and increased recurrence risk. To critically review current evidence on return to sport (RTS), recurrence, rehabilitation strategies, and surgical decision-making after ABR, with specific focus on contact athletes and sport-specific insights from ice hockey. A focused narrative review of recent systematic reviews, meta-analyses, cohort studies, and sport-specific investigations related to RTS, recurrence, rehabilitation, and surgical strategy after ABR was performed. RTS rates after ABR are high (≈79-91%), with 60-70% returning to preinjury level. Contact athletes demonstrate similar RTS rates compared to non-contact athletes but significantly higher recurrence rates (≈17% vs 8%). Objective functional and psychological criteria improve outcomes compared to time-based protocols. Sport-specific data from ice hockey demonstrate excellent RTS rates despite persistent concerns regarding recurrence and long-term durability. Although ABR enables high rates of RTS in contact athletes, RTS alone may overestimate surgical success, as recurrence risk remains substantially elevated in high-demand populations. Risk-stratified surgical selection and criteria-based rehabilitation are therefore essential.