Arthroscopic Bankart repair: A matched cohort comparison of the modified Mason Allen method and the simple stitch method

Abstract

Introduction Arthroscopic Bankart repair (ABR) has become a standard treatment for recurrent anterior shoulder dislocation in cases with minimal bone loss. Using the standard Bankart repair technique, the failure rate has been reported to be approximately between 4 and 35%. In addition to the original injury, multiple pathologies can occur after a dislocation including a Bankart lesion, capsular redundancy and bone defects. In cases with no significant bone loss, soft tissue plays a major role in stabilizing the shoulder joint. We hypothesized that effective repair of soft tissue with good inferior capsular shifting and proper capsulolabral restoration can create a proper level of soft tissue tension so the horizontal mattress suture method should improve outcomes. Materials and methods A retrospective cohort study was conducted by reviewing the records of patients with recurrent anterior instability who underwent ABR at a single institution between January 2009 and December 2017. Demographic information, preoperative radiographic data including glenoid bone loss, Hill-Sachs width, glenoid track and other surgical details were retrieved from the medical records. The patients identified were divided into 2 groups. Group 1 had one modified Mason Allen stitch plus simple stitches, while Group 2 had only simple stitches. Data obtained from the patient included failure rate, patient satisfaction, the ROWE score and Walch-Duplay score at a minimum of 2 years after surgery. Risk factors for failure were also identified. Results Group 1 included 50 patients (mean age 27.2 ± 9.4 years) who underwent modified Mason Allen stitch ABR (median follow-up, 59.2 months; range, 26.2–128.6 months). Group 2 included 30 patients (mean age 26.9 ± 8.5 years) who underwent simple stitch repair ABR (median follow-up, 68.0 months; range, 24.0–127.9 months). All patients met the inclusion criteria. Evaluation at the final follow-up compared Group 1 and Group 2: ROWE score (86.8 vs 76.3, P = 0.001), Walch-Duplay score (87.2 vs 82.0, P = 0.035), respectively. Failure rates were 6% in group 1 compared to 10% in group 2 (P = 0.511). Conclusions The modified Mason Allen stitch technique and the simple stitches technique ABR both result in excellent patient satisfaction at a minimum 2-year follow-up. Both techniques successfully restore shoulder stability, but the modified Mason Allen stitch technique results in better functional outcomes. Study design Cohort study; level of evidence, 3.

Functional Results of Modified Mason-Allen Suture versus Horizontal Mattress Suture in the Arthroscopic Broström-Gould Procedure for Chronic Ankle Instability

“…In addition, Santos et al [13] studied the biomechanics of simple suture and modi ed Mason-Allen suture in the Bankart lesions swine model, and found that the modi ed Mason-Allen suture provides increased labrum height, and meanwhile, the modi ed Mason-Allen suture had the same biomechanical strength advantage as simple suture. Siripipattanamongkol et al [14] retrospectively analyzed 80 patients with Bankart lesions, followed up for at least 2 years, and conducted a comparative study on the e cacy of modi ed Mason-Allen suture and simple suture in the treatment of shoulder glenolip lesions. The results showed that both the two methods of glenolip suture restored the stability and range of motion of shoulder joint.…”

“…Modi ed Mason-Allen suture was originally used for hand surgery tendon suture, but now it is mainly used for rotator cuff tear, labrum of shoulder joint, meniscus posterior root and achilles tendon repair. Its characteristics are mainly characterized by "straddle" locking, strong tissue holding force and pull force, small suture cutting force and relatively simple execution [13][14][15]. Now, no clinical studies have reported functional outcomes of modi ed Mason-Allen suture therapy for CAI in ABG.…”

Functional results of modified Mason–Allen suture versus horizontal mattress suture in the arthroscopic Broström–Gould procedure for chronic ankle instability

“…The biomechanical benefit of the modified Mason-Allen suture was identical to that of the simple suture. Siripipattanamongkol et al [23] compared the efficacy of modified Mason-Allen suture and simple suture in the treatment of shoulder glenoid lesions using a retrospective analysis of 80 patients with Bankart lesions who were followed for at least 2 years. The results indicated that both the two glenoid sutures techniques restored the shoulder joint stability and range of motion.…”

“…However, it is currently mostly employed for rotator cuff tear, labrum of the shoulder joint, meniscus posterior root, and Achilles tendon repair. Its characteristics are mainly characterized by "straddle" locking, strong tissue holding force and pull force, small suture cutting force, and relatively simple execution [22][23][24]. Currently, no clinical studies have reported functional outcomes of modified Mason-Allen suture therapy for CAI in ABG.…”

Modified Mason–Allen Knot for Arthroscopic Complex Bankart Lesion Repair in Recurrent Anterior Shoulder Instability

“…Siripipattanamongkol et al. 16 in a retrospective cohort study compared a group of 50 patients who underwent modified Mason–Allen Stitch for arthroscopic Bankart repair with a group of 30 patients who underwent a simple stitch arthroscopic Bankart repair and found in both groups excellent patient satisfaction and shoulder stability restoration at a minimum 2-year follow-up. The modified Mason–Allen stitch was, however, associated with better functional outcomes at the final follow-up, with a significantly improved Walch–Duplay score (87.2 vs 82.0; P = .035) and Rowe score (respectively 86.8 vs 76.3; P = .001) and a nonsignificant trend for a lower failure rate with, respectively, 6% and 10% ( P = .511).…”