Revision Arthroscopic Labral Repair Using All-Suture Anchors in Patients With Subcritical Glenoid Bone Loss After Failed Bankart Repair: Clinical Outcomes at 2-Year Follow-up

Abstract

Background: All-suture anchors have been used for primary arthroscopic Bankart repair because of their ability to minimize initial bone loss. Purpose: To evaluate the clinical efficacy of using all-suture anchors in revision arthroscopic labral repair after failed Bankart repair. Study Design: Case series; Level of evidence, 4. Methods: Enrolled in this study were 28 patients who underwent revision arthroscopic labral repair with all-suture anchors after a failed primary arthroscopic Bankart repair. Revision surgery was determined for patients who had a frank redislocation history with subcritical glenoid bone loss (<15%), nonengaged Hill-Sachs lesion, or off-track lesion. Minimum 2-year postoperative outcomes were evaluated using shoulder range of motion (ROM), the Rowe score, the American Shoulder and Elbow Surgeons (ASES) score, apprehension, and the redislocation rate. Postoperative shoulder anteroposterior radiographs were assessed to evaluate arthritic changes in the glenohumeral joint. Results: The mean patient age was 28.1 ± 6.5 years, and the mean time between primary Bankart repair and revision surgery was 5.4 ± 4.1 years. Compared with the number of suture anchors used in the primary operation, significantly more all-suture anchors were inserted in the revision surgery (3.1 ± 0.5 vs 5.8 ± 1.3, P < .001). During the mean follow-up period of 31.8 ± 10.1 months, 3 patients (10.7%) required reoperation because of traumatic redislocation and symptomatic instability. Of patients with symptoms that did not require reoperation, 2 patients (7.1%) had subjective instability with apprehension depending on the arm position. There was no significant change between preoperative and postoperative ROM. However, ASES (preoperative: 61.2 ± 13.3 to postoperative: 81.4 ± 10.4, P < .01) and Rowe (preoperative: 48.7 ± 9.3 to postoperative: 81.7 ± 13.2, P < .01) scores were significantly improved after revision surgery. Eight patients (28.6%) showed arthritic changes in the glenohumeral joint on final plain anteroposterior radiographs. Conclusion: Revision arthroscopic labral repair using all-suture anchors demonstrated satisfactory 2-year clinical outcomes in terms of functional improvement. Postoperative stability was obtained in 82% of patients without recurrent shoulder instability after failed arthroscopic Bankart repair.