Histologic analysis of bony Bankart lesions in recurrent anterior instability of the shoulder

Fujii, Yasuhiro; Yoneda, Minoru; Wakitani, Shigeyuki; Hayashida, Kenji

doi:10.1016/j.jse.2005.06.006

Cited by 49 publications

(47 citation statements)

References 11 publications

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“…Although three-dimensionally reconstructed CT remains the only method of calculating the glenoid bone loss objectively, conventional radiographs may provide sufficient accuracy for clinical decision-making [4,24]. Fujii et al [6] stated after a histological analysis of 27 samples of bony Bankart lesions that the fragment may be viable and be used for repairing the glenoid defect even in cases of chronic instability which has been present for years. The treatment goal of all operative and non-operative techniques is the anatomic reconstruction of the glenoid joint surface.…”

Section: Discussionmentioning

confidence: 99%

Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients

Raiss

Baumann

Akbar

et al. 2008

Knee Surg Sports Traumatol Arthrosc

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The aim of this retrospective study was to analyse the clinical, functional and radiographic outcomes of patients sustaining traumatic anterior dislocations of the shoulder in combination with large anterior glenoid rim fractures, treated by open reduction and internal screw fixation (ORIF). Twenty-nine patients with a mean follow-up of 6.5 years (2.5-12 years) were evaluated clinically using the Constant and DASH scores, radiographs in two planes and isokinetic muscle strength measurement (Biodex 3 PRO). Mean age was 41.6 years (17-68 years). There was no case of postoperative re-dislocation. Eight out of 29 patients (27.5%) underwent revision surgery to remove the screws. The mean age- and gender-adjusted Constant score was 93.3% (range 64-102%), and the mean DASH score was 10.1 points (range 0-71 points). On radiological examination, 6 patients had signs of osteoarthritis: Samilson type I (n = 3) and II (n = 3). Significant differences for maximal strength in external rotation and muscular endurance compared to the unaffected side were found (P < 0.035). Twenty-seven patients (93%) were satisfied or very satisfied with the result after surgery. ORIF seems to be a good treatment option in cases of large glenoid rim fractures to avoid re-dislocation in the mid-term. Prospective randomised studies are necessary to compare these findings with those after non-operative or arthroscopic treatment of these injuries.

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Section: Discussionmentioning

confidence: 99%

Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients

Raiss

Baumann

Akbar

et al. 2008

Knee Surg Sports Traumatol Arthrosc

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“…The mean number of sutures used per repair to secure the glenoid fragment and labrum back into anatomic position was 3.4 (range, [3][4][5]. Only one knotless anchor (Pushlock Anchor; Arthrex) was used to fix the osseous fragment.…”

Section: Resultsmentioning

confidence: 99%

“…The treatment goal for a bony Bankart lesion is different than that for a non-bony Bankart lesion. Fujii et al 5) reported that all bony fragments in bony Bankart lesions were viable in a histological study and suggested that these fragments could be used to treat a fractured glenoid defect. The primary treatment goal for a bony Bankart lesion should be fixation of the fragment on the glenoid rim, regardless of remnant fragment size.…”

Section: Discussionmentioning

confidence: 99%

“…4) In a histological study, all bony fragments in bony Bankart lesions were viable and were used to treat fractured glenoid defects. 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.…”

Section: Introductionmentioning

confidence: 99%

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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

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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)

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“…Auch bei chronischen Läsionen konnte für die Bankart-Fragmente in einer histologischen Untersuchung eine ausreichende Vitalität festgestellt werden, sodass eine Refixation prinzipiell auch Sinn machen kann [43]. Um ein adäquates Ergebnis erreichen zu können, kommt der Fragmentgröße und der Fragmentmobilisation eine entscheidende Bedeutung zu, da diese für eine adäquate Reposition essenziell sind.…”

Section: Kleiner Knochenverlust (Erosiv)unclassified

Die ossäre Bankart-Läsion

et al. 2014

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Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Non-operative treatment can be successful for small, acute fractures, which are anatomically reduced after shoulder reduction. However, in patients with a high risk profile for recurrent instability initial Bankart repair is recommended. Additionally, bony fixation is recommended for acute fractures that involve more than 15-20% of the inferior glenoid diameter. On the other hand chronic fractures are generally managed on a case-by-case basis depending on the amount of fragment resorption and bony erosion of the anterior glenoid with high recurrence rates under conservative therapy. When significant bone loss of the anterior glenoid is present, anatomical (e.g. iliac crest bone graft and osteoarticular allograft) or non-anatomical (e.g. Latarjet and Bristow) reconstruction of the anterior glenoid is often indicated.

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Histologic analysis of bony Bankart lesions in recurrent anterior instability of the shoulder

Cited by 49 publications

References 11 publications

Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients

Open screw fixation of large anterior glenoid rim fractures: mid- and long-term results in 29 patients

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

Die ossäre Bankart-Läsion

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