When appropriately indicated, isolated arthroscopic Bankart repair remains an excellent option for anterior glenohumeral instability in athletes

Background Outcomes after isolated arthroscopic Bankart repair (ABR) depend on patient selection in athletes. Methods Retrospective cohort of athletes <30 years undergoing isolated ABR (2017–2020) with minimum 4-year follow-up. Exclusions: >10% glenoid bone loss, off-track Hill–Sachs, humeral avulsion of the glenohumeral ligament, superior labrum from anterior to posterior/posterior labral tears, prior surgery, hyperlaxity, multidirectional instability, acute bony Bankart, and collision sports. Outcomes: return to sport (RTS), Rowe, Subjective Shoulder Value (SSV), and Athletic Shoulder Outcome Scoring System (ASOSS). Recurrence was dislocation or clinically verified subluxation. Kaplan–Meier recurrence-free survival (RFS) and crude Cox regression by sport type were used. Results 215 athletes met eligibility criteria and underwent isolated ABR; 205 completed follow-up; median age 20 years. Mean follow-up was 5.87 years (range: 4.0–7.75). RTS was 93.2%, and 86.8% returned to preinjury level at 5.09 ± 1.03 months. Rowe improved 45→95, SSV 50→90, and ASOSS 53→93 (all p < . 001). Rowe minimal clinically important difference was achieved by 94.6% and ASOSS PASS by 100%. RFS was 95.5% at 4 years and 93.1% at 6 years; contact–overhead athletes showed lower RFS (HR 2.5; p = .03). Conclusion Isolated ABR in selected athletes younger than 30 years was associated with a high rate of RTS, excellent functional outcomes, and a low recurrence rate at mid-term follow-up. Level of evidence IV.