Can capsular plication compensate the lack of one suture anchor in an arthroscopic three suture anchor Bankart repair? A comparative study

Acta Orthop Traumatol Turc. 2019 Jul;53(4):266-271. doi: 10.1016/j.aott.2019.04.003. Epub 2019 Apr 30.

Abstract

Objective: The aim of this study was to compare the complication rates and clinical results of labral repair with two suture anchors and capsular plication, and labral repair with three suture anchor fixation in artroscopic Bankart surgery.

Methods: Sixty-nine patients (60 males, 9 females; mean age: 28.2 ± 7.8 years (range: 16-50)) who had undergone arthroscopic repair of a labral Bankart lesion were evaluated. Group A underwent an arthroscopic Bankart repair with three knotless suture anchors, while group B underwent a modified arthroscopic Bankart repair with two knotless suture anchors and an additional capsular plication procedure. The mean follow-up was 52.5 months. Constant Shoulder Score (CSS), Rowe Score (RS), modified UCLA Shoulder Score (mUSS) and range of motion (ROM) were used as outcome measures.

Results: In both groups, a significant improvement was detected in functional outcomes at postoperative last follow-up compared to the preoperative period. No statistically significant difference was found (p > 0.05) in clinical scores (CSS; Group A: 89.7, Group B: 80.2) (RS; Group A: 88.2, Group B: 80.2) (mUSS; Group A: 26.3, Group B: 25.7) external rotation loss (At neutral; Group A: 4.5°, Group B: 5.2°. At abduction; Group A: 4.3°, Group B: 5.7°) and recurrence rates (Group A: 13.3%, Group B: 20.8%). Although the difference was not statistically significant, the recurrence rate was higher in group B (20.8%), compared to group A (13.3%), despite the shorter average follow-up time of group B (p = 0.417).

Conclusions: Arthroscopic repair of labral Bankart lesions with both techniques showed good functional outcomes and stability at the latest follow-up. Higher recurrence rate despite the shorter average follow-up of group B suggests that two anchor usage might not be sufficient for Bankart repair in terms of better stability and less recurrence risk.

Level of evidence: Level III, Therapeutic Study.

Keywords: Anchor number; Arthroscopic repair; Capsular plication; Labral Bankart lesion; Surgical outcome; Traumatic recurrent anterior shoulder instability.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthroplasty* / adverse effects
  • Arthroplasty* / methods
  • Arthroscopy / adverse effects
  • Arthroscopy / methods
  • Bankart Lesions* / diagnosis
  • Bankart Lesions* / surgery
  • Female
  • Humans
  • Joint Instability* / diagnosis
  • Joint Instability* / etiology
  • Joint Instability* / surgery
  • Male
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / etiology
  • Range of Motion, Articular
  • Recurrence
  • Shoulder Dislocation* / diagnosis
  • Shoulder Dislocation* / etiology
  • Shoulder Injuries
  • Shoulder Joint* / surgery
  • Suture Anchors* / adverse effects
  • Suture Anchors* / classification
  • Treatment Outcome