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Clinical Outcome after Surgical Treatment of Recurrent Shoulder Dislocation with Small Bony Bankart

  • Kim, Jung-Han (Department of Orthopaedic Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Chang-Wan (Department of Orthopaedic Surgery, Busan Paik Hospital, Inje University College of Medicine)
  • Received : 2014.08.31
  • Accepted : 2015.06.08
  • Published : 2015.09.30

Abstract

Background: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. Methods: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). Results: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. Conclusions: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.

Keywords

References

  1. Robinson CM, Dobson RJ. Anterior instability of the shoulder after trauma. J Bone Joint Surg Br. 2004;86(4):469-79. https://doi.org/10.1302/0301-620X.86B4
  2. Simonet WT, Melton LJ 3rd, Cofield RH, Ilstrup DM. Incidence of anterior shoulder dislocation in Olmsted County, Minnesota. Clin Orthop Relat Res. 1984;(186):186-91.
  3. Bui-Mansfield LT, Banks KP, Taylor DC. Humeral avulsion of the glenohumeral ligaments: the HAGL lesion. Am J Sports Med. 2007;35(11):1960-6. https://doi.org/10.1177/0363546507301081
  4. Fujii Y, Yoneda M, Wakitani S, Hayashida K. Histologic analysis of bony Bankart lesions in recurrent anterior instability of the shoulder. J Shoulder Elbow Surg. 2006;15(2):218-23. https://doi.org/10.1016/j.jse.2005.06.006
  5. Gerber C, Nyffeler RW. Classification of glenohumeral joint instability. Clin Orthop Relat Res. 2002;(400):65-76.
  6. Habermeyer P, Gleyze P, Rickert M. Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: a prospective study. J Shoulder Elbow Surg. 1999; 8(1):66-74. https://doi.org/10.1016/S1058-2746(99)90058-7
  7. Mizuno N, Yoneda M, Hayashida K, Nakagawa S, Mae T, Izawa K. Recurrent anterior shoulder dislocation caused by a midsubstance complete capsular tear. J Bone Joint Surg Am. 2005;87(12):2717-23. https://doi.org/10.2106/JBJS.E.00027
  8. Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med. 1997;25(3):306-11. https://doi.org/10.1177/036354659702500306
  9. Bigliani LU, Newton PM, Steinmann SP, Connor PM, Mcllveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med. 1998;26(1):41-5. https://doi.org/10.1177/03635465980260012301
  10. Black KP, Lim TH, McGrady LM, Raasch W. In vitro evaluation of shoulder external rotation after a Bankart reconstruction. Am J Sports Med. 1997;25(4):449-53. https://doi.org/10.1177/036354659702500406
  11. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16(7):677-94. https://doi.org/10.1053/jars.2000.17715
  12. Greis PE, Scuderi MG, Mohr A, Bachus KN, Burks RT. Glenohumeral articular contact areas and pressures following labral and osseous injury to the anteroinferior quadrant of the glenoid. J Shoulder Elbow Surg. 2002;11(5):442-51. https://doi.org/10.1067/mse.2002.124526
  13. Hovelius LK, Sandstrom BC, Rösmark DL, Saebo M, Sundgren KH, Malmqvist BG. Long-term results with the Bankart and Bristow-Latarjet procedures: recurrent shoulder instability and arthropathy. J Shoulder Elbow Surg. 2001;10(5):445-52. https://doi.org/10.1067/mse.2001.117128
  14. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am. 2000; 82(1):35-46. https://doi.org/10.2106/00004623-200001000-00005
  15. Lazarus MD, Sidles JA, Harryman DT 2nd, Matsen FA 3rd. Effect of a chondral-labral defect on glenoid concavity and glenohumeral stability. A cadaveric model. J Bone Joint Surg Am. 1996;78(1):94-102. https://doi.org/10.2106/00004623-199601000-00013
  16. Pouliart N, Marmor S, Gagey O. Simulated capsulolabral lesion in cadavers: dislocation does not result from a bankart lesion only. Arthroscopy. 2006;22(7):748-54. https://doi.org/10.1016/j.arthro.2006.04.077
  17. Speer KP, Deng X, Borrero S, Torzilli PA, Altchek DA, Warren RF. Biomechanical evaluation of a simulated Bankart lesion. J Bone Joint Surg Am. 1994;76(12):1819-26. https://doi.org/10.2106/00004623-199412000-00008
  18. Zuckerman JD, Gallagher MA, Cuomo F, Rokito A. The effect of instability and subsequent anterior shoulder repair on proprioceptive ability. J Shoulder Elbow Surg. 2003;12(2):105-9. https://doi.org/10.1067/mse.2003.4
  19. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy. 2007;23(9):985-90. https://doi.org/10.1016/j.arthro.2007.05.009
  20. Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am. 2006;88(8):1755-63. https://doi.org/10.2106/JBJS.E.00817
  21. Apreleva M, Hasselman CT, Debski RE, Fu FH, Woo SL, Warner JJ. A dynamic analysis of glenohumeral motion after simulated capsulolabral injury. A cadaver model. J Bone Joint Surg Am. 1998;80(4):474-80. https://doi.org/10.1302/0301-620X.80B3.8285
  22. Balg F, Boileau P. The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br. 2007;89(11):1470-7.
  23. Lauman U. Kinesiology of the shoulder joint. In: Kobel R, ed. Shoulder replacement. New York: Springer Verlag; 1987.
  24. Lippitt SB, Vanderhooft JE, Harris SL, Sidles JA, Harryman DT 2nd, Matsen FA 3rd. Glenohumeral stability from concavitycompression: a quantitative analysis. J Shoulder Elbow Surg. 1993;2(1):27-35. https://doi.org/10.1016/S1058-2746(09)80134-1
  25. Malicky DM, Soslowsky LJ, Blasier RB, Shyr Y. Anterior glenohumeral stabilization factors: progressive effects in a biomechanical model. J Orthop Res. 1996;14(2):282-8. https://doi.org/10.1002/jor.1100140217
  26. Novotny JE, Nichols CE, Beynnon BD. Kinematics of the glenohumeral joint with Bankart lesion and repair. J Orthop Res. 1998;16(1):116-21. https://doi.org/10.1002/jor.1100160120
  27. Mologne TS, Provencher MT, Menzel KA, Vachon TA, Dewing CB. Arthroscopic stabilization in patients with an inverted pear glenoid: results in patients with bone loss of the anterior glenoid. Am J Sports Med. 2007;35(8):1276-83. https://doi.org/10.1177/0363546507300262