Arthroscopic Repair of Glenoid Fractures Using Suture Anchors

Sugaya, Hiroyuki; Kon, Yoshiaki; Tsuchiya, Akihiro

doi:10.1016/j.arthro.2005.02.006

Cited by 116 publications

(135 citation statements)

References 11 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…5) Thus, primary fixation should be attempted to decrease the glenoid defect, regardless of the bony fragment size. Various surgical techniques [6][7][8][9][10][11][12][13][14] to treat bony Bankart lesions have been described. Arthroscopic or open reduction is performed to fix the bony Bankart lesion to the glenoid depend-…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

Lee

Kim

Kho

et al. 2017

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates. (Clin Shoulder Elbow 2017;20(3):138-146)

show abstract

Section: Introductionmentioning

confidence: 99%

“…An arthroscopic technique has many advantages, such as anatomic repair with a direct view, decreased invasiveness and tissue trauma, and a concomitant pathological diagnosis. Many arthroscopic methods have been used; 8,10,13,[15][16][17][18] however, they all have major limitations, including technical challenge.…”

mentioning

confidence: 99%

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

Lee

Kim

Kho

et al. 2017

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

show abstract

“…[2][3][4][5] The existence of numerous methods is evidence that there is still no established method for surgery.In the 2000s, new methods utilizing suture anchors were designed. However, this technique could not provide sufficient contact area for the fractured fragment because the suture crossed the surface of the fracture and the bony fragment could tilt because of the one-point fixation.…”

mentioning

confidence: 99%

“…[2][3][4][5] The existence of numerous methods is evidence that there is still no established method for surgery.…”

mentioning

confidence: 99%

EDITORIAL : Is the Arthroscopic "Multiple Pulled Suture" Technique a Good Solution for Large or Comminuted Bony Bankart Lesions

Kim

2017

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

Numerous surgical procedures have been developed since restoration of the anterior-inferior glenoid was raised as an important factor for restoring the stability of the shoulder joint 1) after acute or chronic shoulder dislocation. [2][3][4][5] The existence of numerous methods is evidence that there is still no established method for surgery.In the 2000s, new methods utilizing suture anchors were designed. However, this technique could not provide sufficient contact area for the fractured fragment because the suture crossed the surface of the fracture and the bony fragment could tilt because of the one-point fixation. To solve this problem, Millett et al. 6) developed the "bony Bankart bridge" procedure;however, this method was technically too difficult. Bauer et al. 7)later introduced the transglenoid technique for arthroscopic repair, which is simpler than techniques using suture anchors, but less accurate due to suture fixation on the fascia of the infraspinatus muscle. Lee et al. 8) modified the transglenoid technique to devise a so-called pulled sutures technique. Their study investigated the multiple pulled suture (MPS) technique in 10 patients with bony Bankart lesions and found excellent clinical and radiological results. Moreover, indirect fixation induced by ligamentotaxis was theoretically described in the discussion section of their study. In their study, 3-dimensionalcomputed tomography scans performed at 3 months postoperation showed union in all patients. However, it is not known whether this method will have the same effect on all large or comminuted bony Bankart lesions. As stated in their paper, if the condition of the capsulolabral complex and the periosteum were poor, the arthroscopic MPS technique could not be performed because it is difficult to induce a ligamentotaxis effect when periosteum damage is severe. Therefore, it is very important to confirm the condition of soft tissues around the bony fragment including the periosteum, using magnetic resonance arthrogram.The MPS technique involves the fixation of MPS onto the 2 or 10 o'clock position on the glenoid with one Pushlock (Arthrex) anchor, a knotless suture anchor. This technique seems to have advantages, such as being simple and more economical than other conventional surgery methods that use an average of four or more suture anchors. Conversely, this method relies on one knotless suture anchor to sustain all of the tension. If this fixation fails, adverse results are obvious. Therefore, the quality of the glenoid bone should be guaranteed so that it can withstand this one suture anchor with excessive tension. In addition, the quality of the soft tissue should be ensured because MPS will be performed on the labroligamentous complex.In this study, 7 out of 10 cases were Bigliani type I lesions and 7 out of 10 cases were first time dislocations. These factors suggest that most patients in this study had better bone quality and capsulolabral complex quality when compared to patients with chronic dislocations, resulting in solid res...

show abstract

“…This has generated substantial awareness concerning bone preservation and precipitated a number of innovative techniques, ranging from screw fixation to multiple configurations of suture repair. 2,[12][13][14][15][16][17][18][19] We present an arthroscopic transosseous technique that we developed at Orthopaedic Research of Virginia that provides anatomic reduction, compressive fixation, and reinforces capsulolabral stability to maximize osseous union and reduce capsular volume.…”

mentioning

confidence: 99%

ORV Arthroscopic Transosseous Bony Bankart Repair

Myer

Caldwell

2012

Arthroscopy Techniques

View full text Add to dashboard Cite

Abstract:The arthroscopic treatment of the "bony Bankart lesion" continues to evolve. We present a novel technique that we developed at Orthopaedic Research of Virginia, the "transosseous bony Bankart repair," which incorporates several essential concepts to provide for optimal healing and rehabilitation. We promote arthroscopic repair emphasizing bone preservation, a fracture interface without interposing sutures, the ability to reduce capsular volume, and multiple points of stable glenolabral fixation. Our technique positions suture anchors within the subchondral bone of the intact glenoid to allow for an anatomic reduction of the bony fragment. By use of an arthroscopic drill, spinal needle, and nitinol suture passing wire, the sutures are passed in a retrograde fashion through the bony Bankart fragment and anterior capsule in a mattress configuration. Additional inferior and superior anchors are placed to further provide stability and reduce capsular volume. While maximizing fracture surface area and optimizing bony healing, the end result is an anatomic reduction of the bony fragment and the glenoid articular surface.

show abstract

Arthroscopic Repair of Glenoid Fractures Using Suture Anchors

Cited by 116 publications

References 11 publications

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

EDITORIAL : Is the Arthroscopic "Multiple Pulled Suture" Technique a Good Solution for Large or Comminuted Bony Bankart Lesions

ORV Arthroscopic Transosseous Bony Bankart Repair

Contact Info

Product

Resources

About