Summary

Characteristics and Treatment Strategies of Bony Bankart Lesion Accompanied with Rotator Cuff Tears

Abstract

Purpose

To investigate the feasibility and clinical outcomes of simultaneous arthroscopic repair for bony bankart lesion and rotator cuff injuries with the utilization of suture anchor technique.

Methods

From June 2008 to January 2015, a total of eighteen patients received simultaneous arthroscopic repair for bony bankart lesion and rotator cuff injuries. There were 10 males and 8 females, the mean age was 57.9 years old (range, 40-72 years). All of the 18 patients had a history of traumatic anterior shoulder dislocation, eleven of them underwent operation because of a redislocation after emergency reduction, and the rest were treated due to a persistent shoulder pain. All patients were confirmed to possess full-thickness rotator cuff tears and bony bankart lesion through magnetic resonance imaging (MRI) combined with X-ray or computed tomography (CT). The bony bankart lesions were repaired firstly with suture anchors, then the single-row suture anchors were applied to repair the rotator cuff tears.

Results

The mean follow-up of the 18 patients was 22.5 months (range, 12-38 months). Compared with the contralateral shoulder, the operated shoulder manifested a less range of motion in terms of forward flexion and external rotation at 3 months and 6 months postoperatively (p<0.05), and the deficit disappeared at the time of 1 year after operation (p>0.05). At the final follow-up, no statistical difference was found between the operated shoulder and contralateral shoulder with regard to the American Shoulder and Elbow Surgeons (ASES)(91.6±6.7 and 93.6±4.8, respectively), Constant-Murley score (89.9±6.8 and 92.0±7.9, respectively), Rowe score (89.3±7.1 and 91.1±6.7, respectively), or abduction strength (p>0.05). Shoulder pain based on visual analog scale (VAS) decreased significantly from 6.2±1.9 points preoperatively to 1.4±1.1 postoperatively (p<0.05). During the follow-up, there was one patient experienced subluxation and three patients occurred postoperative ankylosis, the conditions were improved after active muscle strength exercise. No infection or redislocation was found during the whole follow-up.

Conclusion

Bony bankart lesion accompanied with rotator cuff tears was not uncommon in old patients who experienced shoulder dislocation, and a simultaneous arthroscopic repair of these two injuries may bring about a satisfactory outcome compared with the normal contralateral side.