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Arthroscopic repair of combined Bankart and SLAP lesions: operative techniques and clinical results.

Cho HL, Lee CK, Hwang TH, Suh KT, Park JW - Clin Orthop Surg (2010)

Bottom Line: We compared the results with the isolated Bankart lesion.VAS for pain was decreased from preoperative 4.9 to postoperative 1.9.There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, Korea.

ABSTRACT

Background: To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations.

Methods: From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislocations who underwent arthroscopic repair. The average age at surgery was 24.2 years (range, 16 to 38 years), with an average follow-up period of 15 months (range, 13 to 28 months). During the operation, we repaired the unstable SLAP lesion first with absorbable suture anchors and then also repaired Bankart lesion from the inferior to superior fashion. We analyzed the preoperative and postoperative results by visual analogue scale (VAS) for pain, the range of motion, American Shoulder and Elbow Surgeon (ASES) and Rowe shoulder scoring systems. We compared the results with the isolated Bankart lesion.

Results: VAS for pain was decreased from preoperative 4.9 to postoperative 1.9. Mean ASES and Rowe shoulder scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1, respectively. There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up. We found the range of motions after the arthroscopic repair in combined lesions were gained more slowly than in patients with isolated Bankart lesions.

Conclusions: In recurrent dislocation of the shoulder with combined Bankart and SLAP lesion, arthroscopic repair using absorbable suture anchors produced favorable clinical results. Although it has technical difficulty, the concomitant unstable SLAP lesion should be repaired in a manner that stabilizes the glenohumeral joint, as the Bankart lesion can be repaired if the unstable SLAP lesion is repaired first.

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Related in: MedlinePlus

MRI findings showing the Bankart lesion (A) and the superior labrum anterior to posterior lesion (B).
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Figure 1: MRI findings showing the Bankart lesion (A) and the superior labrum anterior to posterior lesion (B).

Mentions: From May 2003 to January 2006, 62 patients underwent arthroscopic repair for recurrent shoulder dislocation at our institution and were followed for more than 12 months. There were 15 patients with arthroscopically confirmed combined Bankart and type II SLAP lesions; the patient cases were reviewed retrospectively. All of the subjects were males with a mean age of 24.2 years (range, 16 to 38 years) and the mean postoperative follow-up period was 15 months (range, 13 to 28 months). There were in 9 cases of the shoulder affected being on the dominant and 6 cases with the affected shoulder on the non-dominant side. All of the patients had greater than 10 experiences of shoulder dislocation. The mean interval from initial dislocation to the index operation was 34 months (range, 21 to 56 months). The clinical outcomes in terms of postoperative pain and range of motion recovery were compared to 15 of the 62 patients, who were selected as the control group. The patients in the control group had isolated Bankart lesions without type II SLAP lesions and were male. The affected shoulder was on the dominant side in 11 cases. The mean age was 24.6 years (range, 18 to 35 years) and the mean postoperative follow-up period was 22 months (range, 21 to 34 months). The preoperative physical tests included the anterior apprehension test, relocation test, O'Brien test, and biceps load test (Table 1). For the identification of osseous lesions, we took anteroposterior, axillary, Stryker notch, and West Point radiographs. There were no osseous Bankart lesions, while there were noted Hill-Sach lesions. In all cases, a Bankart lesion and a SLAP lesion was observed on the horizontal MRI and the coronal MRI, respectively (Fig. 1).


Arthroscopic repair of combined Bankart and SLAP lesions: operative techniques and clinical results.

Cho HL, Lee CK, Hwang TH, Suh KT, Park JW - Clin Orthop Surg (2010)

MRI findings showing the Bankart lesion (A) and the superior labrum anterior to posterior lesion (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2824094&req=5

Figure 1: MRI findings showing the Bankart lesion (A) and the superior labrum anterior to posterior lesion (B).
Mentions: From May 2003 to January 2006, 62 patients underwent arthroscopic repair for recurrent shoulder dislocation at our institution and were followed for more than 12 months. There were 15 patients with arthroscopically confirmed combined Bankart and type II SLAP lesions; the patient cases were reviewed retrospectively. All of the subjects were males with a mean age of 24.2 years (range, 16 to 38 years) and the mean postoperative follow-up period was 15 months (range, 13 to 28 months). There were in 9 cases of the shoulder affected being on the dominant and 6 cases with the affected shoulder on the non-dominant side. All of the patients had greater than 10 experiences of shoulder dislocation. The mean interval from initial dislocation to the index operation was 34 months (range, 21 to 56 months). The clinical outcomes in terms of postoperative pain and range of motion recovery were compared to 15 of the 62 patients, who were selected as the control group. The patients in the control group had isolated Bankart lesions without type II SLAP lesions and were male. The affected shoulder was on the dominant side in 11 cases. The mean age was 24.6 years (range, 18 to 35 years) and the mean postoperative follow-up period was 22 months (range, 21 to 34 months). The preoperative physical tests included the anterior apprehension test, relocation test, O'Brien test, and biceps load test (Table 1). For the identification of osseous lesions, we took anteroposterior, axillary, Stryker notch, and West Point radiographs. There were no osseous Bankart lesions, while there were noted Hill-Sach lesions. In all cases, a Bankart lesion and a SLAP lesion was observed on the horizontal MRI and the coronal MRI, respectively (Fig. 1).

Bottom Line: We compared the results with the isolated Bankart lesion.VAS for pain was decreased from preoperative 4.9 to postoperative 1.9.There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, Korea.

ABSTRACT

Background: To evaluate the clinical results and operation technique of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP) lesions, all of which had an anterior-inferior Bankart lesion that continued superiorly to include separation of the biceps anchor in the patients presenting recurrent shoulder dislocations.

Methods: From May 2003 to January 2006, we reviewed 15 cases with combined Bankart and SLAP lesions among 62 patients with recurrent shoulder dislocations who underwent arthroscopic repair. The average age at surgery was 24.2 years (range, 16 to 38 years), with an average follow-up period of 15 months (range, 13 to 28 months). During the operation, we repaired the unstable SLAP lesion first with absorbable suture anchors and then also repaired Bankart lesion from the inferior to superior fashion. We analyzed the preoperative and postoperative results by visual analogue scale (VAS) for pain, the range of motion, American Shoulder and Elbow Surgeon (ASES) and Rowe shoulder scoring systems. We compared the results with the isolated Bankart lesion.

Results: VAS for pain was decreased from preoperative 4.9 to postoperative 1.9. Mean ASES and Rowe shoulder scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1, respectively. There were no specific complication and no significant limitation of motion more than 10 degree at final follow-up. We found the range of motions after the arthroscopic repair in combined lesions were gained more slowly than in patients with isolated Bankart lesions.

Conclusions: In recurrent dislocation of the shoulder with combined Bankart and SLAP lesion, arthroscopic repair using absorbable suture anchors produced favorable clinical results. Although it has technical difficulty, the concomitant unstable SLAP lesion should be repaired in a manner that stabilizes the glenohumeral joint, as the Bankart lesion can be repaired if the unstable SLAP lesion is repaired first.

Show MeSH
Related in: MedlinePlus