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.