2015 ISAKOS Biennial Congress Paper #0

The Glenoid Index: A New Risk Factor For Recurrence Of Glenohumeral Instability After Arthroscopic Bankart Repair

Agustin Albani, MD, Ciudad de Buenos Air, Buenos Aires ARGENTINA
Luciano Rossi, PhD, Buenos Aires ARGENTINA
Rodrigo Nicolás Brandariz, MD, San isidro, Buenos Aires ARGENTINA
Ignacio Tanoira, MD PhD, Buenos Aires ARGENTINA
damian dimemmo, MD, Ciudad de Buenos Air, Buenos Aires ARGENTINA
Maximiliano Ranalletta, MD, Buenos Aires, Buenos Aires ARGENTINA
Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Buenos Aires, ARGENTINA

FDA Status Cleared

Summary: In young active patients with an arthroscopic Bankart repair a glenoid index > 1.58 had 3.86 times the risk of recurrence than those subjects with a GI = 1.58.

Abstract:

Purpose

The purpose of this study was to compare the GI (Glenoid-Index) of patients operated on for ABR (Arthroscopic Bankart Repair) who had recurrences with those who did not, and to determine if GI is a risk factor for recurrence after ABR.

Methods

Between 2014 and 2018, 148 patients = 18 years old with anterior glenohumeral instability underwent a primary arthroscopic Bankart repair in our institution. We excluded patients with glenoid bone loss, off track Hill Sachs lesions, or incomplete follow-up. We assessed return to sports, functional outcomes and complications. We evaluate the association between the altered GI and the probabilities of recurrence in the postoperative period. Intraclass correlation coefficient (ICC) was used to determine interobserver reliability.

Results

The mean age at time of surgery was 25,6 years old (19 to 29), the mean follow-up was 53,3 months (29 to 89). The 95 shoulders who met the inclusion criteria were divided into 2 cohorts, 47 shoulders had a GI =1.58 (Group A) and 48 had a GI >1.58 (Group B). At final the follow-up, 5 shoulders in group A (10.6%) and 17 shoulders in group B (35,4%) suffered a recurrence of instability. Those patients with a GI > 1.58 had a hazard ratio of 3,86 (95%CI: 1,42-10,48) (p=0,004) compared with those with a GI = 1.58 of suffering a recurrence. When correlating glenoid index measurements between raters, we observed an intraclass correlation coefficient (ICC) of 0.76 (95% CI: 0.63-0.84), these results fall under the qualitative definition of good interobserver agreement.

Conclusion

In young active patients with an arthroscopic Bankart repair an increased GI was associated with significant higher rate of postoperative recurrences. Specifically, those subjects with a GI > 1.58 had 3.86 times the risk of recurrence than those subjects with a GI = 1.58.
Level of evidence: 3, retrospective cohort study.