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Inclusion criteria were the following: collision and contact sports activities, recurrent anterior instability associated with hyperlaxity and glenoid bone loss (GBL) &lt; 15%. Exclusion criteria were GBL &gt; 15%, voluntary instability, multidirectional instability, pre\u2010existing osteoarthritis and throwing athletes. The minimum follow\u2010up was 24 months. Hyperlaxity was clinically evaluated according to Neer and Coudane\u2010Walch tests. Before surgery, all patients underwent magnetic resonance imaging and computed tomography scanning. Pico area method was used to assess the percentage of GBL. Patients were operated on by 6 surgeons, and their functional outcomes were evaluated by 2 independent observers. The Western Ontario Shoulder Instability Index (WOSI), Rowe, American Shoulder and Elbow Surgeons (ASES) scores were used to assess results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 397 patients with evidence of shoulder hyperlaxity (positive sulcus sign in ER1 position and Coudane\u2010Walch test &gt; 85\u00b0) met\u00a0all inclusion criteria. The mean WOSI score was 321; the mean Rowe score rose from 68.5 to 92.5 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .037), and the ASES score rose from 71.5 to 97.4 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .041). Seven patients (1.6%) had atraumatic redislocation, and 9 patients (2.2%) had post\u2010traumatic redislocation. At final follow\u2010up the mean functional deficit of external rotation was 15\u00b0 with the arm in adduction (ER1 position) and 10\u00b0 in abduction (ER2 position).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Bankart repair plus ASA has been demonstrated to be safe and effective for restoring joint stability in patients practicing collision and contact sports or affected by chronic anterior shoulder instability associated with GBL (&lt;15%) and hyperlaxity, without compromising external rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  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