High Psychological Resilience Is Associated With Higher Patient-Reported Outcomes After Arthroscopic Bankart Repair
- 1Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- 2Department of Orthopedics and Sports Medicine, Sutter Health, Sacramento, California, USA
Abstract
Background: 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 P < .05. 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; P = .034), higher SSV scores (82.8 ± 18.3 vs 72.9 ± 23.5, respectively; P = .037), and lower VAS scores (1.5 ± 2.1 vs 2.7 ± 2.8, respectively; P = .028) than the LR group. On multivariable linear regression, recurrent instability predicted an 864-point increase in the WOSI score ( P < .001). However, high psychological resilience reduced this impact by 677 points ( P = .001) compared to low psychological resilience. 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.
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BibTeX
@article{gilbert2026high,
title = {{High Psychological Resilience Is Associated With Higher Patient-Reported Outcomes After Arthroscopic Bankart Repair}},
author = {Ryan Gilbert BA and Ryan T. Lin MD and Sahil Dadoo MD and Neel Bhardwaj BS and Abigail Balsan BS and Jonathan D. Hughes MD, PhD and Adam Popchak DPT, PhD and Bryson P. Lesniak MD and Mark Rodosky MD and Albert Lin MD},
journal = {Orthopaedic Journal of Sports Medicine},
year = {2026},
month = oct,
doi = {10.1177/23259671261492458},
url = {https://doi.org/10.1177/23259671261492458},
note = {CC BY},
}
RIS
TY - JOUR
TI - High Psychological Resilience Is Associated With Higher Patient-Reported Outcomes After Arthroscopic Bankart Repair
AU - Ryan Gilbert BA
AU - Ryan T. Lin MD
AU - Sahil Dadoo MD
AU - Neel Bhardwaj BS
AU - Abigail Balsan BS
AU - Jonathan D. Hughes MD, PhD
AU - Adam Popchak DPT, PhD
AU - Bryson P. Lesniak MD
AU - Mark Rodosky MD
AU - Albert Lin MD
PY - 2026
DA - 2026/10/23
JO - Orthopaedic Journal of Sports Medicine
DO - 10.1177/23259671261492458
UR - https://doi.org/10.1177/23259671261492458
AB - Background: 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 P < .05. 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; P = .034), higher SSV scores (82.8 ± 18.3 vs 72.9 ± 23.5, respectively; P = .037), and lower VAS scores (1.5 ± 2.1 vs 2.7 ± 2.8, respectively; P = .028) than the LR group. On multivariable linear regression, recurrent instability predicted an 864-point increase in the WOSI score ( P < .001). However, high psychological resilience reduced this impact by 677 points ( P = .001) compared to low psychological resilience. 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.
SN - 2325-9671
ER -