Benefits of bone graft augmentation to arthroscopic Bankart repair for recurrent anterior shoulder instability with glenoid bone loss

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-07, Vol.28 (7), p.2325-2333
• Main Authors: Iizawa, Norishige, Yoneda, Minoru, Yamada, Shinichi, Mizuno, Naoko, Goto, Kazuki, Iwashita, Satoshi, Mae, Tatsuo, Hashiguchi, Hiroshi, Takai, Shinro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Amputation; Arthroplasty - methods; Arthroscopy - methods; Athletes; Augmentation; Autografts; Bankart Lesions - surgery; Biomedical materials; Bone grafts; Bone loss; Bone Transplantation; Female; Grafting; Grafts; Humans; Hydroxyapatite; Instability; Joint Instability - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Range of Motion, Articular; Scapula - surgery; Shoulder; Shoulder - surgery; Shoulder Dislocation - surgery; Shoulder Joint - surgery; Skin & tissue grafts; Sports; Stability; Stability augmentation; Substitute bone; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-019-05746-2

Purpose Glenoid bone loss contributes to recurrent instability after arthroscopic Bankart repair alone. With significant glenoid bone loss, better results have been reported after arthroscopic Bankart repair with glenoid arc reconstruction. However, no reports compare augmentation using bone graft with non-augmentation for glenoid bone loss. The purpose of this study was to assess clinical results of an arthroscopic Bankart repair with or without arthroscopic bone graft augmentation. It was hypothesized that such bone graft augmentation would restore shoulder stability, and lead to excellent outcomes. Methods Of 552 patients treated for anterior glenohumeral instability with arthroscopic Bankart repair, 68 met this study’s inclusion criteria of glenoid bone loss over 20% and follow-up of at least 2 years. Patients were divided into 2 groups based on whether with bone graft augmentation for glenoid bone loss [Group A: n  = 35, median age; 21 years (range 13–72 years)], or not (Group B: n  = 33, median age; 21 years (range 13–50 years)]. For grafting, either autologous iliac bone or artificial bone made of hydroxyapatite was used. Rowe score, recurrence rate, and return to sport were used to assess the results. Results Mean Rowe score was 95.0 (SD 10.6) in Group A and 69.7 (SD 27.2) in Group B ( p