Quantitative Assessment of Glenohumeral Translation After Anterior Shoulder Dislocation and Subsequent Arthroscopic Bankart Repair

• Published in: The American journal of sports medicine 2006-11, Vol.34 (11), p.1756-1762
• Main Authors: Marquardt, Björn, Hurschler, Christof, Schneppendahl, Johannes, Witt, Kai-Axel, Pötzl, Wolfgang, Steinbeck, Jörn
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroscopy; Arthroscopy - methods; Athletes; Biological and medical sciences; Cadaver; Diseases of the osteoarticular system; Dislocation; Endoscopy; Health aspects; Humans; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Joint Instability - physiopathology; Medical sciences; Middle Aged; Range of Motion, Articular - physiology; Risk factors; Robotics; Rotation; Shoulder; Shoulder dislocation; Shoulder Dislocation - physiopathology; Shoulder Dislocation - surgery; Shoulder joint; Sports injuries; Sports medicine; Suture Anchors; Traumas. Diseases due to physical agents
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546506289702

Background: During the past decade, developments in arthroscopic technology have made arthroscopic repair of labral lesions feasible. However, results with the use of the transglenoid suture technique, or with the use of bioabsorbable tacks, have remained variable in the literature, and the recurrence rates are still inferior to those of open Bankart repair. Hypothesis: Arthroscopic Bankart repair with suture anchors can re-create translational and rotational range of motion of the intact glenohumeral joint, and the number of preoperative dislocations has an influence on the result. Study Design: Controlled laboratory study. Materials: Twelve cadaveric shoulders were tested in a robot-assisted shoulder simulator. Anterior and posterior translation and external rotation were measured for intact, dislocated (shoulders were randomly selected to 1 of 3 groups, which were dislocated 1, 3, or 7 times), and repaired conditions at 0° and 90° of glenohumeral elevation. Results: After shoulder dislocation, a significant increase was found in translation and rotation, confirming the creation of a traumatic shoulder instability model. Further testing of the specimen revealed that translational and rotational ranges of motion were reduced by arthroscopic Bankart repair at both testing positions. External rotation was decreased significantly at 0° and 90° of abduction. No significant differences were found between the 3 dislocation groups. Conclusion: The results demonstrate a sufficient biomechanical performance of arthroscopic Bankart repair using suture anchors in a traumatic anterior shoulder instability model. With the numbers available, no relationship was found between the number of dislocations and the postoperative result concerning translational or rotational motion. Clinical Relevance: Glenohumeral translation and rotation after arthroscopic Bankart repair with use of suture anchors approached near normal values, confirming the clinical success of this technique. Keywords: anterior shoulder instability arthroscopic Bankart repair biomechanics cadaveric model