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Single Working Portal Technique for Knotless Arthroscopic Bankart Repair.

ABSTRACT: Arthroscopic Bankart repair is widely accepted as the method of choice in restoring the labrum to the glenoid rim. It has been shown to have comparable outcomes with open stabilization. This usually involves the use of 2 portals anteriorly: one anterosuperior accessory portal and another anteroinferior working portal. The aim of this Technical Note is to present a simple and reproducible technique for Bankart repair using a single working portal anteriorly without an accessory portal.

SUBMITTER: Ng DZ

PROVIDER: S-EPMC5797850 | biostudies-other | 2017 Oct

REPOSITORIES: biostudies-other

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Single Working Portal Technique for Knotless Arthroscopic Bankart Repair.

Ng Dennis Zhaowen DZ Lau Bernard Puang Huh BPH Tan Bryan Hsi Ming BHM Kumar V Prem VP

Arthroscopy techniques 20171023 5

Arthroscopic Bankart repair is widely accepted as the method of choice in restoring the labrum to the glenoid rim. It has been shown to have comparable outcomes with open stabilization. This usually involves the use of 2 portals anteriorly: one anterosuperior accessory portal and another anteroinferior working portal. The aim of this Technical Note is to present a simple and reproducible technique for Bankart repair using a single working portal anteriorly without an accessory portal. ...[more]

PMID: 29416984

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The "Labral Bridge": A Novel Technique for Arthroscopic Anatomic Knotless Bankart Repair.

Project description:Arthroscopic Bankart repair with suture anchors is widely considered a mainstay for surgical treatment of anterior shoulder instability after recurrent anterior shoulder dislocations. Traditionally, the displaced capsulolabral complex is restored and firmly attached to the glenoid by placing multiple suture anchors individually from a 5- to 3-o'clock position. A variety of different techniques using different anchor designs and materials have been described. Knotless anchors are widely used nowadays for shoulder instability repair, providing a fast and secure way of labral fixation with favorable long-term outcomes. However, these techniques result in a concentrated point load of the reduced labrum to the glenoid at each suture anchor. We describe a technique, developed by the first author, using a 1.5-mm LabralTape (Arthrex, Naples, FL) in combination with knotless suture anchors (3.5-mm PEEK [polyether ether ketone] PushLock anchors; Arthrex), for hybrid fixation of the labrum. The LabralTape is used to secure the torn labrum to the glenoid between each suture anchor, thus potentially providing a more even pressure distribution.

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Arthroscopic Knotless, Tensionable All-Suture Anchor Bankart Repair.

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Patients Have a 15% Redislocation Rate After Arthroscopic Bankart Repair With a Knotless Technique.

Project description:PurposeTo evaluate the redislocation rate after arthroscopic Bankart repair (ABR) with a standardized knotless anchor technique in a consecutive series of patients with anterior glenohumeral instability.MethodsInclusion criteria were patients who underwent ABR by a single surgeon between January 2008 and December 2018 with a minimum follow up of 2 years. We collected data through phone interviews, Western Ontario Shoulder Instability Index, and review of patient records. The primary outcome was redislocation and secondary outcomes were recurrent subluxations, reoperation, postoperative complications, patient satisfaction, and functional outcomes. We also performed survival analysis and risk factor analysis.ResultsOf 88 patients (91 shoulders) who underwent ABR during the inclusion period, 70 patients (73 shoulders) were included (follow-up rate 80%). The mean follow-up was 7.5 years (range 2-12 years). Redislocation occurred in 15% (95% confidence interval [CI] 7.8%-25.4%) of patients at a mean of 41 months after surgery (range 6-115 months). The reoperation rate for recurrent redislocation was 4.1%. Overall, 90.4% reported being currently satisfied with their shoulder and the mean Western Ontario Shoulder Instability Index score at follow-up was 73.8% (range 8.3%-99.9%). Patients with redislocation were younger at primary operation than patients with no redislocation (mean 21 years vs 28 years; P = .023) and adjusted hazard ratio for age was 0.86 (95% CI 0.74-0.99; P = .033). It was more common to have less than 3 anchors in patients with redislocation (P = .024), but adjusted hazard ratio was 4.42 (95% CI 0.93-21.02; P = .061).ConclusionsThe redislocation rate after ABR with a standardized knotless anchor technique in a consecutive series of patients with anterior glenohumeral instability was found to be 15% after a minimum 2-year follow-up (mean 7.5).Level of evidenceLevel IV, therapeutic case-series.

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Arthroscopic Double-Row Bony Bankart Bridge Repair Using a Tensionable Knotless System.

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All-arthroscopic knotless suture anchor repair of triangular fibrocartilage complex fovea tear by the 2-portal technique.

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Arthroscopic Knotless Repair of Complete Full-Thickness Tears of the Subscapularis Tendon Through a Single Portal.

Project description:Arthroscopic repair of subscapularis tendon tears has shown to be a reliable and reproducible technique and is now considered the gold standard method over open repair. However, most arthroscopic techniques use several working portals and the procedure can be technically challenging and time-consuming, especially when knot-tying is required and when multiple anchors are used. Recently, single-portal knotless techniques have been popularized for upper-third lesions (e.g. Lafosse type 1 or 2 tears). Here, we describe a technique of repairing complete tears of the subscapularis tendon (Lafosse type 3 and 4) using knotless suture anchors through a single portal. This technique is quick and allows a safe anatomic footprint repair to the lesser tuberosity.

| S-EPMC7188956 | biostudies-literature

Arthroscopic repair of chronic bony bankart lesion using a low anterior portal.

Project description:We describe the repair of a chronic bony Bankart lesion in a case with recurrent instability using standard techniques and equipment for addressing anteroinferior glenohumeral instability. A 25-year-old man with recurrent instability and a chronic bony Bankart lesion with a Hill-Sachs lesion was treated. The inferior 2 sutures and knotless anchors are placed through a low anterior portal, which improves the angle of approach to the inferior portion of the glenoid that is fractured. The knotless anchors are impacted through the low anterior portal, just superior to the level of the suture, as the fragment tends to retract medially and inferiorly, with the drill guide slightly on the face of the glenoid. The superior-anterior portal adjacent to the biceps tendon gives a better view of the glenoid articular cartilage position of the anchors required to restore the anatomic location of the fracture fragment. The low anterior portal improved and simplified the reduction of the fracture fragment to the glenoid neck by allowing access to the anterior-inferior bony Bankart lesion that was repairable with suture and knotless anchors using standardized techniques.

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Arthroscopic Bony Bankart Repair Using a Double-Row Double-Pulley Technique.

Project description:We propose an arthroscopic technique called "double-row double-pulley" to restore a bony Bankart lesion. This technique is a 2-point fixation construct using the sutures from a medial row anchor at the glenoid neck to wrap around the bony Bankart fragment and tie to the sutures from a lateral row anchor at the glenoid rim with the double-pulley method. This technique may present some difficulty with suture management, but there are several advantages. First, due to the 2-point fixation, the risk of a bone piece fracture from direct penetration is minimized. Moreover, the fragment can be reduced directly due to the multiple knots that are tied sequentially over the bony fragment.

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