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This Article Full Text Full Text (PDF) All Versions of this Article: 35/12/2067    most recent 0363546507305011v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Porcellini, G. Articles by Paganelli, M. Search for Related Content PubMed PubMed Citation Articles by Porcellini, G. Articles by Paganelli, M. Related Collections Dislocations Shoulder Arthroscopy

Long-term Outcome of Acute Versus Chronic Bony Bankart Lesions Managed Arthroscopically

Giuseppe Porcellini, MD^,*, Paolo Paladini, MD, Fabrizio Campi, MD and Massimo Paganelli, MD

From the Unit of Shoulder Surgery, "D. Cervesi" Hospital, Cattolica, Italy, and the Department of Orthopaedics, University of Ferrara, Ferrara, Italy

^* Address correspondence to Giuseppe Porcellini, MD, Unit of Shoulder Surgery, "D. Cervesi" Hospital, Via L. V. Beethoven 1, 47841 Cattolica (RN), Italy (e-mail: chirurgiaspalla{at}virgilio.it).

Background: Acute bony Bankart lesions can be successfully treated with an arthroscopic approach to fix the avulsed bone fragment to the glenoid without grafting.

Hypothesis: Chronic bony Bankart lesions with glenoid defects can be repaired arthroscopically in the same manner as acute lesions.

Study Design: Cohort study; Level of evidence, 2.

Methods: Over 6 years, 215 of 406 unstable shoulders were managed with an arthroscopic approach. A bony Bankart lesion was detected in 68 (31.6%); of these, 41 were operated on <3 months after the first dislocation (acute group) and 27 at a longer interval (chronic group). Preoperative evaluation was by radiography and computed tomography. A modified Bankart technique was used to repair the capsulolabral complex and fix the avulsed bone fragment to the healthy glenoid with suture anchors. Long-term follow-up data (at least 4 years) were available for 65 patients (41 acute and 24 chronic). Preoperative and postoperative Rowe scores were compared.

Results: One patient from the acute group (2.4%) and 1 patient in the chronic group (4.2%) experienced traumatic redislocation. The mean postoperative Rowe scores increased, from 59 to 92 and from 43.5 to 61, respectively (both P < .001).

Conclusion: An arthroscopic procedure using suture anchors appears to enable successful treatment of acute bony Bankart lesions. Chronic lesions had less favorable outcomes.

Key Words: acute chronic bony Bankart • arthroscopy • shoulder instability • glenoid fracture