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Restoration of joint congruency and the glenoidal labrum after arthroscopic revision Bankart repair: a MRI match-paired analysis comparing primary Bankart repair and the uninjured labrum

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

The restoration of joint congruency and labrum slope and height after arthroscopic revision Bankart repair (RB) compared to the primary arthroscopic Bankart repair (PB) remain unclear.

Methods

Twenty-three consecutive patients after RB with minor glenoid deficits were matched to 23 patients after PB and retrospectively followed by a score system and native 1.5 T magnetic resonance imaging (MRI) assessment. Bankart repair surgeries were performed using double-loaded knotless suture anchors. The glenoidal (GAA) and labral articulation arc (LAA), labrum slope, height index and morphology were assessed separately for the anterior and inferior glenoid and compared to 23 healthy volunteers [radiologic control group (RC)].

Results

Arthroscopic revision Bankart repair showed 28.0 months post-operative equivalent anterior labral congruency (LAA, 9.3°/PB 9.9°/RC 10.1°) and inferior (LAA 9.9°/PB 9.6°/RC 10.5°). The anterior GAA remain decreased (54.6°/PB 55.7°/RC 58.0°) with an original inferior GAA (85.1°/PB 83.2°/RC 83.8°). The RB labrum was slightly decreased anteriorly (slope 22.9°/PB 23.9°/RC 24.6°; height index 2.4/PB 3.0/RC 3.2). The inferior portion had an equivalent labrum slope (23.8°/PB 24.7°/RC 25.1°), but a decreased height index (2.1/PB 2.2/RC 2.3). Morphologic labrum analysis revealed significant changes between all three groups. The clinical outcome after revision surgery was good-to-excellent, but inferior to the primary stabilization and without influence of joint congruency and labrum morphology to the clinical outcome.

Conclusion

A properly applied arthroscopic revision of a Bankart repair generates sufficient restoration of the anteroinferior labral joint congruency and good clinical results.

Study design

Case series.

Level of evidence

3.

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Acknowledgments

The authors appreciate the assistance of Dr. med. Christian Reck for the radiologist advisements and Dr. rer. med. Hanns Ackermann, Brigitte Mack, and Gamze Tercan for collection and analyzing the data.

Conflict of interest

The magnetic resonance imaging was partially financed by third-party funds (Fa. Arthrex, Naples, FL/USA).

Author information

Authors and Affiliations

  1. Department of Sporttraumatology, Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany

    T. Stein, J. Buckup, A. P. Mehling & F. Welsch

  2. Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik, Frankfurt am Main, Germany

    R. Hoffmann

  3. Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany

    T. Efe

  4. Clinic of Orthopedics and Traumatology, Technical University, Munich, Germany

    R. von Eisenhart-Rothe

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  1. T. Stein
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Correspondence to T. Stein.

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T. Stein and J. Buckup contributed equally to this work.

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Stein, T., Buckup, J., Mehling, A.P. et al. Restoration of joint congruency and the glenoidal labrum after arthroscopic revision Bankart repair: a MRI match-paired analysis comparing primary Bankart repair and the uninjured labrum. Arch Orthop Trauma Surg 134, 1121–1134 (2014). https://doi.org/10.1007/s00402-014-1990-z

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