Shoulder arthroscopy: part II arthroscopic Bankart repair for anterior shoulder instability using suture anchor reconstruction technique

ABSTRACT

Suture anchor reconstruction technique was used in 19 shoulders over the last 2.7 years in 19 patients in an attempt to restore anterior stability. All the patients had traumatic anterior instability diagnosed on physical examination and at arthroscopy. Discrete Bankart lesion and well formed glenohumeral ligaments, with or without capsular laxity was the evidence consistent with instability in all patients, and each underwent a standardized procedure, however, the number of anchors were different for every patient, range 1-to-3 according to the size of the lesion. Additional capsulorraphy procedures were done to reduce excess capsular volume including; plication sutures in 8 shoulders, and thermal shrinkage in 7. All patients were young active men with high physical demands, the average age at the time of operation was 25.2 years. All were right handed, the dominant side was affected in 11 patients. None of the patients had prior instability operations. The follow-up averaging 18 months, range 9-to-3 1 months. None of the patients developed redislocation, subluxation, or positive apprehension during the follow-up period. No major intra-operative, or pen-operative complications were reported during this study. 75%-to-full range of motion of the shoulder joint as compared with the opposite asymptomatic side was preserved 21 in most patients. Using the shoulder evaluation scale advocated by Rowe; and Zarins, 1981 1421, the patients had excellent-to-good results with an overall average score of 85.82 points; but 5 patients had episodes of moderate pain with activity, and 7 had moderate limitation in overhead work. It would appear that arthroscopic repair of pathologic Bankart lesion in a carefully selected patients using suture anchor technique is a favorable answer restoring stability to the shoulder better than non-operative treatment of first-time dislocation and to surgical treatment of recurrent shoulder dislocation