Open Bankart repair with suture anchors for traumatic recurrent anterior shoulder instability: comparison of results between small and large Bankart lesions

Abstract

This retrospective study was to demonstrate the clinical outcome of open Bankart repair with suture anchors for recurrent anterior shoulder instability, and to compare surgical results of small (<3 clock units) and large (>3 clock units) Bankart lesions. With an average follow‐up of 55.6 months (2–8 years), there were 82 patients (60 right, 22 left shoulders) with the mean age of 27 years accepting open Bankart repair with suture anchors and capsular shift procedure by the same team. According to surgical findings, these patients were grouped into small (<3 clock units) and large (>3 clock units) Bankart lesions. Subjective outcomes were recorded according to the Bankart scoring system of Rowe. Rowe scores averaged 85.9±12.9 (range 25–100). The patients, 92–7 %, had objectively excellent or good results. Twenty nine patients (35.4%) had small Bankart lesions and 53 patients had large Bankart lesions. The Rowe scores in small Bankart lesions were better than that in large Bankart lesions (93.5±6.8 vs.81.8±13.6, Wilcoxon rank sum test, P<0.001). Mean scores of stability (Wilcoxon rank sum test, P=0.043), motion (Wilcoxon rank sum test, P=0.037), and function (Wilcoxon rank sum test, P<0.001) in small lesions also had superior outcomes than in large lesions. Four patients (4.9%) got fair results and two (2.4%) patients got poor results at the end of follow‐up. The average loss of external rotation is 10°. Open Bankart repair with the aid of suture anchors still got satisfactory results in the treatment of traumatic recurrent anterior instability of the shoulder. The size of the Bankart lesion was a factor affecting surgical outcome. Small Bankart lesions usually got better results than large Bankart lesions.

Return to Play After Open Bankart Repair

“…All 96 articles were individually reviewed by 2 reviewers, resulting in 29 articles that met the inclusion criteria and were included in this report ( Figure 1 ). 2 – 5 , 7 – 20 , 22 – 33 …”

Blood supply and vascularity of the glenoid labrum: Its clinical implications

“…29 Open Bankart repair with suture anchors associated with the capsular shift procedure was more effective in small Bankart lesions compared to large ones. 30 Kamath et al 31 reported that two double-loaded suture anchors were better or equal to three single-loaded suture anchors because it needed fewer anchor holes in the glenoid bone, thus decreasing the incidence of postsurgical glenoid fracture. In patients who underwent an arthroscopic bony Bankart bridge to treat a Bankart lesion, there was an average glenoid bone loss of 29% ( n = 14): Millett et al 32 observed that successful joint stability was achieved in 93%.…”

“…29 Open Bankart repair with suture anchors associated with the capsular shift procedure was more effective in small Bankart lesions compared to large ones. 30 Kamath et al 31 reported that two double-loaded suture anchors were better or equal to three single-loaded suture anchors because it needed fewer anchor holes in the glenoid bone, thus decreasing the incidence of postsurgical glenoid fracture.…”

Open Reconstruction of Large Bony Glenoid Erosion with Allogeneic Bone Graft for Recurrent Anterior Shoulder Dislocation

“…8,17,18,20 This indicates the need for anatomic bone reconstruction in cases of large defects of the anterior glenoid rim. Lai et al 16 and Rhee and Lim 24 found that Bankart lesion size is an important factor in surgical outcome after Bankart repair with simple capsular reattachment. Regardless of this technique being arthroscopic or open, they concluded that poor surgical outcomes would follow from large bony Bankart lesions.…”

“…The defects are associated with poor arthroscopic stabilization outcome without bone graft for significant bony loss of the anterior glenoid. 4,6,16,26,31…”