The arthroscopic Bankart repair procedure enables complete quantitative labrum restoration in long-term assessments

  • J. Bock
  • J. Buckup
  • Y. Reinig
  • E. Zimmermann
  • C. Colcuc
  • R. Hoffmann
  • F. Welsch
  • Thomas Stein
Shoulder
  • 25 Downloads

Abstract

Purpose

The restoration of the labrum complex and the influence on secondary osteoarthritis after arthroscopic Bankart repair on magnetic resonance imaging (MRI) remain unclear.

Methods

Twenty-one patients were retrospectively followed after unilateral primary arthroscopic Bankart repair with knot-tying suture anchors (8.8 ± 2.5 years after surgery, age 25.3 ± 6.3 years). Bilateral structural MRI was performed to assess labrum–glenoid restoration by measurements of the labrum slope angle, height index, and labrum interior morphology according to the Randelli classification. Osteoarthritic status was bilaterally assessed by a modified assessment based on the Samilson–Prieto classification.

Results

MRI assessment revealed full labrum–glenoid complex restoration with equivalent parameters for anterior slope angle (mean ± SD: 21.3° ± 2.6° after Bankart repair vs. 21.9° ± 2.6° control) and height index (2.34 ± 0.4 vs. 2.44 ± 0.4), as well as the inferior slope angle (23.1° ± 2.9° vs. 23.3° ± 2.1°) and height index (2.21 ± 0.3 vs. 2.21 ± 0.3) (all n.s.). The labrum morphology showed only for the anterior labrum significant alterations (1.4 ± 0.9 vs. 0.6 ± 0.7, p < 0.05), the inferior labrum occurred similarly (1.3 ± 0.8 vs. 0.8 ± 0.5, n.s.). Osteoarthritic changes were significantly increased after Bankart repair compared to the uninjured shoulder (4.8 ± 5.1 mm vs. 2.5 ± 1.0 mm; p < 0.05), with a significant correlation of osteoarthritis status between both shoulders (p < 0.05). Scores generally decreased after Bankart repair (constant 84.6 ± 9.5 vs. 94.5 ± 4.9 control, p < 0.05; Rowe 84.5 ± 6.5 vs. 96.2 ± 4.2, p < 0.05; Walch–Duplay 82.4 ± 7.0 vs. 94.3 ± 4.0, p < 0.05) with a strong correlation with osteoarthritis status (p < 0.05).

Conclusions

Arthroscopic Bankart repair enabled good clinical outcomes and complete quantitative labrum restoration parameters. Next to several well-known parameters, secondary osteoarthritis after arthroscopic Bankart repair significantly correlated with osteoarthritic status of the uninjured contralateral shoulder but was not influenced by quantitative labrum restoration. The recommendation for arthroscopic Bankart repair should be based on clinical parameters and not on prevention of secondary osteoarthritis.

Study design

Case series.

Level of evidence

IV.

Keywords

Bankart repair Labrum restoration Longterm Shoulder stabilization Knotless anchor 

Notes

Compliance with ethical standards

Conflict of interest

Bock J, Buckup J, Reinig Y, Zimmermann E, Colcuc C, Hoffmann R and Welsch F declared no conflicts of interest. Stein T has received payments for instructions at human cadaver courses.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards and the vote of the ethical committee. All data collection and randomizing procedures were approved by the institutional ethics committee 2009.

Informed consent

Informed consent was obtained from all participants included in the study.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  1. 1.Department of Sport Traumatology–Knee- and Shoulder-SurgeryBerufsgenossenschaftliche Unfallklinik Frankfurt am MainFrankfurt am MainGermany
  2. 2.Department of Trauma and Orthopedic SurgeryBerufsgenossenschaftliche Unfallklinik Frankfurt am MainFrankfurt am MainGermany
  3. 3.Department of Sports ScienceUniversity of BielefeldBielefeldGermany

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