2017 ISAKOS Biennial Congress ePoster #2013

 

Early Results of the Arthroscopic Double Bankart Bridge Technique for Restoration of the Labral Footprint in Arthroscopic Anterior Instability Repair of the Shoulder

Mohamed Aboalata, MD, EBOT, Bad Neustadt an der Saale, Deutschland GERMANY
Abdelsamie Mohammed Halawa, MD, Cairo EGYPT
Khaled Mansoura Nour , MD, Mansoura, Dakahlia EGYPT
Moheib Sayed Ahmed, MD, Mansoura, Dakahlia EGYPT
Yehia E. Bassiouny, MD, Mansoura, Dakhlia EGYPT

Upper Limb Unit, Orthopaedic Department, Mansoura University, Mansoura, Dakahlia, EGYPT

FDA Status Cleared

Summary

Evaluation of the results of a newly proposed technique to improve the saurface area and contact pressure of the capsulolabral footprint in arthroscopic anterior shoulder inatability repair

Abstract

Introduction

Results of the arthroscopic Bankart repair for the anterior shoulder instability showed increasing success rate in the last years. However, the results are generally are still inferior to what has been reported in the literature by most of the open capsulolabral repair procedures. Improvements of the arthroscopic techniques may be required to improve the possible technical week points that may affect the healing at the capsulolabral interface and thus the clinical results. One important factor is the area and contact pressure of the capsulolabral footprint to the glenoid.

Methods

Patients who underwent a modified arthroscopic procedure (the double Bankart bridge technique (DBB) for repair of anterior shoulder instability were recruited at a minimum of one year after surgery. The technique is performed utilizing two knotted anchors at the 5.30 and 4 o’clock positions of the glenoid and incorporating their sutures into a third knotless anchor at the 3 o’clock position thus producing a uniform compression over the whole foot print from the 5.30 to the 3 o’clock positions. Patients were evaluated with the VAS for pain and instability, ASES, ROWE, Constant scores as well as the Dawson-12-items questionnaire). Patient’s data registry was reviewed to asses the factors that may affect the results (number and type of the fixation devices, umber of preoperative dislocations, concomitant lesions, age at the time of dislocation and operation, time interval between the first dislocation and operation).

Results

20 patients were available for follow-up after at a minimum of two years. The mean follow up duration was 26.7 months. There was a significant improvement of the various clinical scores used (ASES: 95.2, ROWE: 91.9, Constant: 96.6 and Dawson: 13.6) (P= 0.03). No single patient has reported any redislocation. Subjective apprehension was reported by only one patient (5%). No patients had persistent postoperative instability requiring revision. The average VAS for pain was 0.75 and for instability 1.1 with a median external rotation deficit of 8°. No patients were unsatisfied with the results of the procedure.
Age of the patients was the only factor significantly associated with higher VAS for subjective postoperative instability.

Discussion And Conclusion

The results of arthroscopic DBB technique showed promising early clinical results which we believe are due to a better healing at the capsulolabral interface to the glenoid resulting from the increased and uniform pressure over the whole foot print.
Further longer-term evaluation including radiological evaluation as well as randomized controlled study with the standard technique are still required for better evaluation of the results.