44
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder.

          Methods

          Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated.

          Results

          SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a Pre and Post Operative Mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation.

          Conclusion

          Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          A standardized method for the assessment of shoulder function.

          The American Shoulder and Elbow Surgeons have adopted a standardized form for assessment of the shoulder. The form has a patient self-evaluation section and a physician assessment section. The patient self-evaluation section of the form contains visual analog scales for pain and instability and an activities of daily living questionnaire. The activities of daily living questionnaire is marked on a four-point ordinal scale that can be converted to a cumulative activities of daily living index. The patient can complete the self-evaluation portion of the questionnaire in the absence of a physician. The physician assessment section includes an area to collect demographic information and assesses range of motion, specific physical signs, strength, and stability. A shoulder score can be derived from the visual analogue scale score for pain (50%) and the cumulative activities of daily living score (50%). It is hoped that adoption of this instrument to measure shoulder function will facilitate communication between investigators, stimulate multicenter studies, and encourage validity testing of this and other available instruments to measure shoulder function and outcome. Copyright © 1994 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Mechanisms of glenohumeral joint stability.

            The biomechanics of glenohumeral stability involve several static and dynamic mechanisms to achieve the intricate balance between shoulder mobility and stability. In conjunction with recent in vitro studies, two important stabilizing mechanisms, concavity compression and scapulohumeral balance, were described. Concavity compression refers to the stability obtained by compressing the humeral head into the concave glenoid fossa. Increasing the magnitude of the compressive load, as provided by dynamic muscle contraction, and the depth of the glenoid concavity, which varies from the asymmetric geometry, enhance concavity compression stabilization. The related scapulohumeral balance refers to the dynamic positioning of the glenohumeral joint so that the joint reaction force is balanced within the glenoid fossa. The greater the arc provided by the glenoid, the larger the range of joint force angles acting through the humeral head that may be stabilized. The presence of an intact glenoid labrum is important to both mechanisms. Concavity compression and scapulohumeral balance may be of particular importance to glenohumeral joint stability in the midrange of motion where the capsuloligamentous constraints are lax. Clinical correlation of these mechanisms contributes to the understanding of glenohumeral instability.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Prospective evaluation of arthroscopic bankart repairs for anterior instability.

              Arthroscopic treatment has evolved to become the primary surgical option in the management of anterior shoulder instability as studies show comparable outcomes between open and arthroscopic techniques. To evaluate prospectively the results of our institutional database for arthroscopic Bankart repairs at a minimum 2-year follow-up for patients with anterior instability treated with suture anchors. Case series; Level of evidence, 4. Eighty-three consecutive patients underwent arthroscopic Bankart repair with suture anchors. The mean age at the time of surgery was 33 years (range, 15-55 years). At an average follow-up of 33 months (range, 24-49 months), 73 patients (61 males, 12 females) were assessed with outcomes scores including the American Shoulder and Elbow Surgeons, L'Insalata, and visual analog scores. The rate of recurrent instability, range of motion, and risk factors for postoperative recurrence were evaluated. Thirteen patients (18%) suffered a recurrence after surgery. Seven patients (10%) had a subsequent dislocation and 6 (8%) a subluxation event or apprehension. Six of the 13 had a traumatic event that resulted in recurrent episodes of instability. Revision surgery was needed for 2 patients (3%) for instability and 2 for postoperative shoulder stiffness. On average there was no significant loss of external rotation postoperatively (average, 71 degrees pre- and postoperatively). The American Shoulder and Elbow Surgeons and L'Insalata scores improved from 75.4 to 94.9 and 66.5 to 90.9, respectively (P 250 mm(3)) Hill-Sachs lesion were associated with recurrence (P 250 mm(3)) Hill-Sachs lesion were at the greatest risk of recurrence.
                Bookmark

                Author and article information

                Journal
                J Orthop Surg Res
                Journal of Orthopaedic Surgery and Research
                BioMed Central
                1749-799X
                2011
                14 June 2011
                : 6
                : 28
                Affiliations
                [1 ]Department of Orthopaedics, Singpapore General Hospital, Outram Road, Singapore 169608, Singapore
                Article
                1749-799X-6-28
                10.1186/1749-799X-6-28
                3127762
                21672187
                c3ace7c0-4617-42e8-8cfd-9c7373183755
                Copyright ©2011 Ee et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 January 2011
                : 14 June 2011
                Categories
                Research Article

                Surgery
                Surgery

                Comments

                Comment on this article