Results Of Arthroscopic Bankart Repair Research Articles

当科における鏡視下 Bankart 修復術の治療成績

当科における鏡視下 Bankart 修復術の治療成績

To Evaluate the Functional Outcome of Arthroscopic Bankart Repair For Traumatic Anterior Shoulder Instability with the Use of Suture Anchors

BackgroundArthroscopic Bankart repair has become increasingly popular as a method for the treatment of anterior shoulder instability. The basis for this enthusiasm has been the impression that it is a less morbid surgical alternative to open repair.AimsThis study aims to evaluate the outcome of arthroscopic Bankart repair in persons with traumatic anterior shoulder instability using suture anchors, in cases that were followed up for at least 2 years from the date of surgery.MethodsThis was series of 20 shoulders in 20 persons who underwent arthroscopic Bankart repair using suture anchors. The patients were assessed with two outcome measurements, i.e. scale of the University of California at Los Angeles (UCLA scale) and simple shoulder test (SST) score. The recurrence rate, range of motion and postoperative functions were evaluated.ResultsThe two shoulder scores significantly improved after surgery (<italic>P-</italic>values &lt; 0.05). According to the UCLA scale, 11 shoulders (55%) had excellent score, 7 (35%) had good score, one shoulder (5%) had a fair score and one (5%) had poor score. All 12 components of SST showed improvement, which was statistically significant. The mean time of return to activity in sportsmen was 8.5 months. Overall, the rate of post-operative recurrences was 10%. There was no loss of external rotation range of motion post-operatively.Arthroscopic Bankart repair with suture anchor is an effective treatment method for traumatic recurrent anterior shoulder instability.

Arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament via horizontal mattress suturing for traumatic shoulder instability

This study aimed to evaluate the two-year clinical outcomes of arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament (IGHL) via horizontal mattress suturing. This study was a retrospective analysis of 76 arthroscopic Bankart repairs by a single surgeon from 2004 to 2008. Bioabsorbable suture anchors were used, with anchors placed at the 5:30, 4 and 3 o'clock positions of the right shoulder (correspondingly at the 6:30, 8 and 9 o'clock positions for the left shoulder). The lower most anchor was tied via horizontal mattress suture with plication of the IGHL, while the remaining two anchors were tied using simple sutures. The patients were postoperatively assessed, clinically and using the University of California Los Angeles (UCLA) shoulder rating scale. The mean age of the patients at the time of presentation was 24.09 ± 7.98 years, and the mean duration of follow-up was 28.7 months. The postoperative recurrence rate of dislocation was 7.89% (six shoulders), of which five shoulders required revision surgeries. Excluding the revision cases, clinical assessment of the strength of the supraspinatus and the range of motion of the operated shoulders at two years post operation were either maintained or full in all patients. Analysis of the UCLA results showed pre- and postoperative mean scores of 25.94 ± 3.43 and 33.77 ± 3.07, respectively (p < 0.05). Arthroscopic Bankart repair augmented by plication of the IGHL and anchored via horizontal mattress suturing is a safe and reliable treatment for shoulder instability, with good clinical outcomes and low recurrence rates.

Arthroscopic repair of Bankart lesion in traumatic anterior-inferior shoulder instability using the two-portal method: A preliminary report

BackgroundIn this report, we describe our preliminary clinical results of arthroscopic Bankart repair in traumatic anterior-inferior shoulder instability using the two-portal method. MethodFrom August 2009 to December 2011, arthroscopic repair of Bankart lesion using this method was performed in 16 consecutive patients who were prospectively enrolled. Fifteen shoulders were treated with two-anchor sutures and one was treated with three-anchor sutures. Twelve patients received metallic anchor screws and four patients received bioanchor screws. The assessments were performed using the Rowe score, the University of California at Los Angeles shoulder rating scale, the American Shoulder and Elbow Surgeons score, and the shoulder range of motion (ROM) deficit. ResultsWith an average follow-up period of 22.9 months, all shoulder scores improved after surgery (p < 0.001). The average ROM deficit of the operated shoulders was not significant as compared with the healthy side in forward elevation (p > 0.05), but was significant in external rotation (p < 0.05). All of the 16 shoulders remained stable (100%) after the arthroscopic repair surgery. All patients returned to their preinjury levels of daily activity without recurrent problems. ConclusionIn patients with traumatic anterior glenohumeral instability, arthroscopic Bankart repair with the two portal method can provide good results. It can be an alternative method of treating patients with Bankart lesion without associated major glenoid defect or rotator cuff lesion in traumatic anterior-inferior instability.

Travmatik anterior omuz çıkıklarında artroskopik bankart tamiri

Arthroscopic bankart repair in the traumatic anterior shoulder dislocation Objective: To analyze the results of arthroscopic Bankart repair for recurrent anterior shoulder dislocations. Material and Method: 16 patients who were performed arthroscopic Bankart repair due to recurrent anterior shoulder dislocation were included in the study. There were four females and 12 males. X ray and Magnetic resonans imaging was admitted for all patients. Results were evaluated according to Rowe and Constant scores. Results: The mean number of dislocations was 10.2, mean Rowe score was 90.6 and mean Constant score was 94.3. Concomitant superior labral anterior and posterior repair was performed for two patients. Three patients had Hill Sachs defects and three patients had defects on the glenoid rim. One patient was detected with traumatic redislocation 15 months after the operation and was reoperated. One patient was reoperated because of intraarticular penetration of the anchor. Mean follow up time was 32.6 months. Conclusion: Arthroscopic bancart repair has good clinical outcome. Increased number of preoperative dislocations may increase the frequency of redo surgery; this should be kept in mind for these

Early outcome of arthroscopic Bankart's repair for recurrent traumatic anterior shoulder instability.

Despite the improvements in the methods of arthroscopic stabilization of anterior shoulder instability, a recurrence rate of as high as 30% is reported in the literature. In this context, we report the outcome of arthroscopic Bankart repair in anterior shoulder instability, with the use of bio-absorbable suture anchors for patients that were followed up for at least two years from the date of surgery. The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2-year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Data from 79 shoulders in 74 patients were collected over 4 years (2005-2009). Each patient was followed up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their anterior shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. SST results from the 12 domains showed a significant improvement from a mean of 6.1±3.1 to 11.1±1.8 taken at the 2-year follow-up (p<0.0001). Data from the UCLA scale showed a pre and post-operative mean of 20.2±5.0 and 32.4±4.6 respectively (p<0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation. Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

Outcomes of Arthroscopic Bankart Repair in Collision Versus Noncollision Athletes

The purpose of the study was to compare the recurrence rate of arthroscopic Bankart repair with suture anchors in collision vs noncollision athletes. Sixty-four patients who underwent arthroscopic shoulder stabilization using suture anchors for recurrent anterior dislocation were identified. Forty-three patients (22 collision and 21 noncollision) were evaluated at a minimum 24-month follow-up. The recurrence rate was reported, and functional outcomes (American Shoulder and Elbow Society, Western Ontario Shoulder Index, and Short Form 12) were evaluated. Statistical analysis was performed using chi-square test and Student's t test with a 95% confidence interval and a significance level set at a P value less than .05. The overall dislocation recurrence rate was 4.6% (2 of 43 patients); the dislocation recurrence rate in collision athletes was 9% (2 of 22 patients), and no redislocations occurred in noncollision athletes. No statistical differences existed in Western Ontario Shoulder Index score (73.5% in collision and 73.4% in noncollision athletes; P=.831), American Shoulder and Elbow Society score (91.2 in collision and 80.7 in noncollision athletes; P=.228), and Short Form 12 score (108.5 in collision and 101.2 in noncollision athletes; P=.083). Average external rotation loss was 6.8° in collision and 5.5° in noncollision athletes (P=.864). Ninety percent of collision athletes vs 95% of noncollision athletes were satisfied. Seventy-three percent of collision and 81% of noncollision athletes were able to return to sport at their preinjury levels. Collision athletes had higher recurrence rates after arthroscopic shoulder stabilization compared with noncollision athletes, but no statistical difference was found. Functional outcomes according to American Shoulder and Elbow Society, Western Ontario Shoulder Index, and Short Form 12 were similar.

Postoperative outcomes of arthroscopic Bankart repair for Self Defense Forces personnel with traumatic shoulder instability

Postoperative outcomes of arthroscopic Bankart repair for Self Defense Forces personnel with traumatic shoulder instability

反復性肩関節前方脱臼に対する鏡視下Bankart修復術の治療成績-Prospective study-

反復性肩関節前方脱臼に対する鏡視下Bankart修復術の治療成績-Prospective study-

Results of arthroscopic Bankart repair in patients with anterior instability of the shoulder

Results of arthroscopic Bankart repair in patients with anterior instability of the shoulder

Clinical outcome of arthroscopic Bankart repair

Clinical outcome of arthroscopic Bankart repair

Minimum 10-Year Follow-up of Arthroscopic Intra-articular Bankart Repair Using Bioabsorbable Tacks

Background: There are few long-term studies evaluating functional outcomes and rates of arthrosis after arthroscopic Bankart repair with bioabsorbable tacks. Purpose: We evaluated the clinical and radiographic results of arthroscopic Bankart repair using intra-articular bioabsorbable tacks at a minimum of 10 years’ follow-up. Study Design: Case series; Level of evidence, 4. Methods: Thirty-two consecutive patients were retrospectively identified. Twenty patients (63%) were evaluated at a mean follow-up of 13.5 years (range, 10.75-17.5 years) and average age of 43 years (range, 28-73 years). The surgical shoulder (SS) was compared with a healthy control shoulder (CS) in 15 of 20 patients. Outcome tools included the Western Ontario Shoulder Instability Index (WOSI) and Disabilities of the Shoulder, Arm, and Hand (DASH). Blinded, independent evaluators performed physical examinations and reviewed radiographs. Results: Thirteen patients (65%) had stable shoulders, 5 of 7 (25%) failed by dislocation, and 2 of 7 (10%) failed by signs of anterior instability on examination. Three patients underwent revision stabilization surgery. Average time to failure was 4.2 years (range, 0.25-14.7 years). Average WOSI and DASH scores were 80% and 7.3, respectively. The CS faired better than SS in WOSI scores (97% vs 83%, respectively; P = .008), main DASH scores (0.39 vs 6.79, respectively; P = .024), and the DASH sports module (0.00 vs 10.94, respectively; P = .043). Patients lost 5.9° of passive forward flexion (P = .031) and 4.3° of passive external rotation (P = .001). Forty percent returned to their preoperative sports level. Higher grades of arthrosis were seen in the SS (20% absent, 40% mild, 25% moderate, and 15% severe) versus CS (P = .002). Conclusion: At long-term follow-up, 65% of patients treated with an arthroscopic Bankart repair using bioabsorbable tacks had a well-functioning, stable shoulder. Disability scores were greatest with sports; however, the majority of patients had well-preserved ranges of motion and good functional WOSI scores. Despite this, 40% had evidence of moderate to severe glenohumeral arthrosis.

Arthroscopic Bankart repair with suture anchors: results and risk factors of recurrence of instability

To evaluate retrospectively the results of arthroscopic Bankart repair using suture anchors for recurrent anterior shoulder dislocation with a minimum 1-year follow-up and to assess risk factors for recurrence. From March 2002 to March 2010, 259 patients with recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with suture anchors. And 188 patients (50 athletes, 138 nonathletes) were available for follow-up. The mean age at the time of surgery was 25.3 years (range, 13 - 58 years). The mean follow-up was 38.6 months (range, 12 - 110 months). All of the 188 patients were evaluated preoperatively and postoperatively with the American Shoulder and Elbow Society (ASES) shoulder score and Rowe score system. The rate of recurrent instability, range of motion, and risk factors for postoperative recurrence were evaluated. The ASES score was 72.6 preoperatively, and Rowe score was 33.4. The ASES scores improved significantly to 91.9 postoperatively (P < 0.001). The Rowe scores improved to 81.9 postoperatively (P < 0.001). And 152 patients were greatly satisfied with the results, 16 satisfied and 20 unsatisfied. The satisfactory rate was 89.4%. 24 patients (12.8%) suffered a recurrence after surgery, 14 athletes and 10 nonathletes. The recurrence rates were 28.0% in the athlete group and 7.2% in the nonathlete group. On average there was no significant loss of external rotation postoperatively (average, 75.2° preoperatively and 67.2° postoperatively). Patients under age 20, and athlete patients were associated with recurrence (P < 0.05). Other factors including length of time until surgery, type of anchors, number of anchors, presence of bony Bankart lesion, presence of a superior labrum, anterior and posterior tear, presence of posterior or inferior labrum lesion, presence of rotator cuff tear, ligamentous laxity and rotator interval closure did not influence the recurrence rate (P > 0.05). Arthroscopic Bankart repair is a good option for the treatment of recurrent anterior shoulder dislocation. Identification of risk factors for recurrence allows for consideration of open stabilization. In the series, patients under age 20 and athlete patients are the most important risk factors for recurrence.

Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

BackgroundThe arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder.MethodsData from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated.ResultsSST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a Pre and Post Operative Mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation.ConclusionArthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

Clinical Outcome of Arthroscopic Bankart Repair for Athletes with Traumatic Anterior Shoulder Instability, Related with the Glenoid Bone Defects

Clinical Outcome of Arthroscopic Bankart Repair for Athletes with Traumatic Anterior Shoulder Instability, Related with the Glenoid Bone Defects

The Functional Results of Arthroscopic Bankart Repair with Knotless Anchors for Anterior Glenohumeral Instability

Aim: The purpose of this study was to evaluate the functional results of arthroscopic Bankart repair in patients with posttraumatic recurrent anterior glenohumeral instability Method: Forty one patients (6 female, 35 male; mean age 24.4; range 19 to 39 years) underwent arthroscopic Bankart repair with knotless anchors for posttraumatic recurrent anterior glenohumeral instability. The mean age that first dislocation occured was 22.3 ( range 16 to 36 years old). Involvement was on the right side in 27 patients, on the left in 14 patients, and on the dominant side in 32 patients. Pre and postoperative evaluations included detailed physical examination, assesment with the Rowe and Constant scale for shoulder functions, anteroposterior and axillary radiographs, routinely arthro-CT and arthro-MRI. Postoperatively the mean follow up was 29.8 months (range to 6 to 62 months). Result: According to Rowe score, the results were excellent in 31 patients (75.7%), good in 6 patients (14.6%), fair in 3 patients (7.3%) and poor in 1 (2.4%) patients. The mean preoperative Rowe score was 20.1, which increased postoperatively 89.1. Preoperative mean Constant scale was 64.2 and 87.6 postoperatively. The mean preoperative active external rotation was 45°, which decreased postoperatively to 40° respectively (p<0.05). Thirty seven (90.2%) patients were satisfied with the operation. The patient with the poor result developed redislocation postoperatively seventh month due to epileptic seizure. Conclusion: This study shows arthroscopic Bankart repair with knotless anchors for recurrent anterior glenohumeral instability is a useful and succesful procedure.

Arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation

Objective To discuss the indications, surgical techniques and results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation. Methods Fourty patients with recurrent anterior shoulder dislocation treated by athroscopic Bankart repair were reviewed with a mean follow- up period of 35.9 (24 -58) months. The mean age was 27.8 (15 -54) years. All patients were diagnosed as unidirectional anterior instability. They were treated with arthroscopic Bankart repair. Metal suture anchors (mini-revo, Linvateo) were used for labral reconstruction during the operation. ASKS score (American Shoulder & Elbow Surgeons' score), Constant- Murley score, Rowe score and VAS score of instability were used for evaluation of shoulder function. Results The preoperative ASKS score , Constant-Murley score and Rowe score were(82.7±16.7), (80.5±11.1)and(30.4±8.7) respectively. After the surgery they improved significantly to (97. 2 ± 6. 9 ), ( 98. 1 ± 3. 1 ) and (92. 8 ± 15.2 ). The preoperative and postoperative VAS score for instability was (6.2 ± 1.6 ) vs ( 1.3 ± 1.4 ). Patients' active forward flexion of affected shoulder waw improved significantly from ( 157.5 ± 20. 6) ° to ( 170. 0 ± 6. 7 )°, while the mean external rotation was (58.5 ± 18.9)° before the surgery comparing with (55.9 ± 15.0)° after the surgery. One patient experienced subluxation during follow-up. Apprehension test was positive in 3 cases(7.5% ), 29 cases(70.7% ) returned to their pre-injury sports level. All but one patients replied Yes when they were questioned as Do you want to accept the same operation if the same condition happens to your contralateral shoulder? Conclusion Arthrescopic Bankart repair is a good option for the treatment of recurrent anterior shoulder dislocation. The success rate of scope surgery matches open reconstruction. Strict indication control, surgeon's skill and comprehensive rehabilitation program are the keys to suoccssful results. Key words: Shoulder dislocation; Arthroscopes; Wounds and injuries; Follow-up studies

鏡視下Bankart修復術 (Morgan法) の術後成績

鏡視下Bankart修復術 (Morgan法) の術後成績

Arthroscopic Revision of Failed Open Anterior Stabilization of the Shoulder (SS-06)

The purpose of this study is to report the results of arthroscopic Bankart repair following failed open stabilization. We reviewed 22 patients with recurrent anterior instability after open surgical stabilization. There were 17 men and five women with an average age of 31 years (range, 15-65). The previous interventions consisted of 16 osseous transfers, three open Bankart repairs and three capsular shifts. The causes of failure were additional trauma in 12 patients and bone-block complications in 13. All patients had distension of the antero-inferior capsule. Labral re-attachment and capsulo-ligamentous re-tensioning with suture anchors was performed in all cases with an additional rotator interval closure in four patients and an inferior capsular plication in 12 patients. The bone block screws were removed in eight patients. Nineteen patients were evaluated at an average follow-up of 43 months (range, 24-72). One patient had recurrent subluxations, and two had persistent apprehension. Eight patients (42%) were still painful. Anterior elevation was unchanged and loss of external rotation was 6°. Nine patients returned to sport at the same level, and all patients returned to their previous occupation. Eighty-nine percent were satisfied or very satisfied. The mean subjective shoulder value (SSV), Walch-Duplay, Rowe and UCLA scores were 83% ± 23%, 85 ± 21, 81 ± 23 and 30 ± 7 points, respectively. Arthroscopic revision of open anterior shoulder stabilization gives satisfactory results. The shoulders are both stable and functional. However, our enthusiasm is tempered by some cases of persistent pain.

Arthroscopic Bankart Repair Using Knotless or BioKnotless Suture Anchors: 2- to 7-Year Results

This study was performed to evaluate the results of arthroscopic Bankart repair, by use of Knotless or BioKnotless suture anchors (DePuy Mitek, Raynham, MA), for traumatic anterior shoulder instability. We performed a retrospective evaluation of 73 consecutive patients with traumatic anterior instability of the shoulder treated with arthroscopic Bankart repair by use of metallic Knotless or BioKnotless suture anchors. No additional capsular plication, thermal modification, or interval closure was performed in any patient. The senior author performed all procedures. Independent examiners performed physical examinations. Self-assessment questionnaire evaluations were completed, and preoperative and postoperative American Shoulder and Elbow Surgeons and Rowe scores are reported. Results at a minimum of 2 years' follow-up (range, 2 to 7 years) are reported for 72 patients (57 male and 15 female patients) available for follow-up evaluation. One patient was lost to follow-up. Of the patients, 5 (6.9%) had post-repair instability (3 dislocations and 2 subluxations). The mean postoperative loss of external rotation, at 90 degrees of abduction, was 1 degrees . All patients who had postoperative instability were aged 22 years or younger. The post-repair instability rate in this age group was 13.5% (5/37). No failures occurred in patients aged over 22 years. Of the post-repair dislocations, 3 (7.5%) were in patients involved in contact or collision sports. All 5 failures occurred early, within 2 years of the index surgery. Revision arthroscopic repairs via Knotless or BioKnotless suture anchors were performed in 3 of 4 patients, and a Latarjet procedure was also performed in the fourth patient. The fifth patient refused further intervention. All of the revision shoulders remained stable at the latest follow-up, 3 of which had at least 2 years of follow-up. Arthroscopic Bankart repair via Knotless or BioKnotless suture anchors showed a recurrence rate of 6.9%. Using Knotless or BioKnotless suture anchors provides satisfactory results with a low recurrence rate, minimal loss of motion, and reliable functional return, even in contact and collision athletes. Level IV, therapeutic case series.