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

Abstract

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.