High Psychological Resilience Is Associated With Higher Patient-Reported Outcomes After Arthroscopic Bankart Repair
Ryan Gilbert, Ryan T. Lin, Sahil Dadoo, Neel Bhardwaj, Abigail Balsan, Jonathan D. Hughes, Adam Popchak, Bryson P. Lesniak, Mark Rodosky, Albert LinBackground:
Psychological resilience is increasingly recognized as an important determinant of recovery after orthopaedic surgery.
Purpose/Hypothesis:
This study aimed to evaluate the association between psychological resilience, measured by the Brief Resilience Scale (BRS), and patient-reported outcomes (PROs) after isolated arthroscopic Bankart repair (ABR) and ABR combined with remplissage (ABR+R). We hypothesized that higher psychological resilience would be associated with superior PROs after ABR and ABR+R.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
All patients who underwent ABR or ABR+R for anterior shoulder instability between 2007 and 2021 were retrospectively reviewed. Exclusion criteria included less than 2 years of follow-up, concomitant rotator cuff repair, or revision stabilization surgery. Patients were contacted by telephone to obtain recurrent instability events; BRS scores; and postoperative PROs including scores for the Western Ontario Shoulder Instability Index (WOSI), visual analog scale (VAS) for pain, and Subjective Shoulder Value (SSV). The BRS is a 6-item questionnaire, with higher scores indicating greater psychological resilience. Patients were categorized as low resilience (LR) or high resilience (HR) based on the cohort's mean BRS score. Correlations between psychological resilience and PROs were assessed using the Spearman rho. Multivariable linear regression evaluated the effects of psychological resilience and recurrent instability on postoperative WOSI scores. Significance was set to
Results:
A total of 85 patients (85 shoulders; mean age, 23 ± 8 years; 72% male) were included at a mean 9.7-year follow-up (range, 3.6-17.2 years). Based on the cohort's mean BRS score of 24.8 ± 4.7, there were 34 patients (40%) categorized as LR (mean BRS, 20.3 ± 3.7) and 51 patients (60%) as HR (mean BRS, 28.0 ± 1.8). The HR group demonstrated superior PROs, with lower WOSI scores (293.7 ± 331.8 vs 496.3 ± 499.5, respectively;
Conclusion:
Our study demonstrated that psychological resilience was significantly correlated with PROs after ABR, with high psychological resilience offering protective effects against inferior PROs, even in patients experiencing recurrent anterior shoulder instability. These findings suggest that psychological resilience assessments and targeted psychological interventions may optimize postoperative recovery and patient satisfaction.