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Glenoid defect associated with anterior shoulder instability: results of open Bankart repair.

ABSTRACT: The purpose of the study was to analyse the clinical results of an open Bankart repair for anterior instability in patients with a glenoid defect and those without a glenoid defect, and to identify factors related to the glenoid defect associated with anterior instability. The prospective study involved 20 patients with a glenoid defect (glenoid defect group) and 20 patients without a glenoid defect (control group) who were enrolled after an open Bankart repair. The average age of each group at the time of surgery was 28 and 23 years respectively. The average follow-up periods were 48 and 55 months. There were no significant differences in subjective pain and stability between the two groups. But the final Rowe score decreased significantly as the size of the glenoid defect increased. Redislocation or subluxation was seen in three patients in the glenoid defect group. The open Bankart procedure restored stability and improved shoulder functions in the patients with a glenoid defect associated with anterior instability, even though the glenoid defect group experienced a significant loss in the range of external rotation with the arm at the side, and the final outcome of the surgery depended upon the size of a glenoid defect. This was a therapeutic, level III case-control study.

SUBMITTER: Rhee YG

PROVIDER: S-EPMC2266647 | biostudies-other | 2007 Oct

REPOSITORIES: biostudies-other

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Project description:PurposeTo evaluate the outcomes of arthroscopic Bankart repair with remplissage (ABRR) compared with the arthroscopic Latarjet (AL) procedure for anterior shoulder instability in patients with a labral tear and a concomitant engaging Hill-Sachs lesion.MethodsA retrospective review of patients who underwent either ABRR or the AL procedure for a diagnosis of anterior shoulder instability with a concomitant engaging Hill-Sachs lesion between 2011 and 2019 was performed. Recurrent instability, the visual analog scale score, the Subjective Shoulder Value, the Western Ontario Shoulder Instability score, patient satisfaction, willingness to undergo surgery again, and return to work or sport were evaluated.ResultsOur study included 41 patients treated with ABRR and 26 treated with the AL procedure. At final follow-up, there was no difference between patients who underwent ABRR and those who underwent the AL procedure in the reported Western Ontario Shoulder Instability score (21.8% vs 28.2%, P = .33) or any of its components, the visual analog scale score (0.9 vs 1.4, P = .32), the Subjective Shoulder Value (78.4 vs 74.5, P = .6062), the rate of satisfaction (81.6% vs 85.6%, P = .54), or whether patients would undergo surgery again (81.6% vs 96.1%, P = .16). Overall, 5 patients in the ABRR group and 2 patients in the AL group had recurrent instability events (12.2% vs 7.8%, P = .70), with no significant difference in the rate of recurrent dislocation (12.2% vs 3.8%, P = .39).ConclusionsIn patients with anterior shoulder instability and a concomitant Hill-Sachs lesion, both ABRR and the AL procedure were shown to be reliable treatments, with a low rate of recurrent instability and excellent patient-reported outcomes in appropriately selected patients. However, our study could not determine whether there was critical glenoid bone loss in patients undergoing ABRR, and surgeons should still exercise caution in performing ABRR in patients with high-grade glenoid bone loss or in those with failed prior stabilizations.Level of evidenceLevel III, retrospective cohort study.

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Glenoid defect associated with anterior shoulder instability: results of open Bankart repair.

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