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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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In type superior labrum anterior to posterior Lesion, the range of motions in (A) forward flexion and (B) external rotation at 90 degree abduction after the arthroscopic repair were gained more slowly than in patients with isolated Bankart lesion (*p < 0.05).
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Figure 7: In type superior labrum anterior to posterior Lesion, the range of motions in (A) forward flexion and (B) external rotation at 90 degree abduction after the arthroscopic repair were gained more slowly than in patients with isolated Bankart lesion (*p < 0.05).

Mentions: Anterior flexion, abduction, and internal rotation of the affected shoulder at the last follow-up were normal as they were before surgery. External rotation did not decrease ≥ 10° when the shoulder was placed in the neutral position and at 90° abduction in all cases. With regard to the time to recovery of the normal range of motion, forward elevation was 120° at the 6th postoperative week and was recovered to normal at the 12th postoperative week. External rotation with the shoulder positioned at 90° abduction improved from 30° at the 9th postoperative week to almost normal by the 6th postoperative month. Between the patients with isolated Bankart lesions and the patients with combined Bankart and SLAP lesions, no significant difference was found in terms of the range of motion measured at the last follow-up. However, the range of motion assessed between the 6th and 9th postoperative week was remarkably low the in the patients with combined Bankart and SLAP lesions. Therefore, the recovery of the normal range of motion was slower in the patients with combined Bankart and SLAP lesions (p < 0.05) (Fig. 7).


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)

In type superior labrum anterior to posterior Lesion, the range of motions in (A) forward flexion and (B) external rotation at 90 degree abduction after the arthroscopic repair were gained more slowly than in patients with isolated Bankart lesion (*p < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: In type superior labrum anterior to posterior Lesion, the range of motions in (A) forward flexion and (B) external rotation at 90 degree abduction after the arthroscopic repair were gained more slowly than in patients with isolated Bankart lesion (*p < 0.05).
Mentions: Anterior flexion, abduction, and internal rotation of the affected shoulder at the last follow-up were normal as they were before surgery. External rotation did not decrease ≥ 10° when the shoulder was placed in the neutral position and at 90° abduction in all cases. With regard to the time to recovery of the normal range of motion, forward elevation was 120° at the 6th postoperative week and was recovered to normal at the 12th postoperative week. External rotation with the shoulder positioned at 90° abduction improved from 30° at the 9th postoperative week to almost normal by the 6th postoperative month. Between the patients with isolated Bankart lesions and the patients with combined Bankart and SLAP lesions, no significant difference was found in terms of the range of motion measured at the last follow-up. However, the range of motion assessed between the 6th and 9th postoperative week was remarkably low the in the patients with combined Bankart and SLAP lesions. Therefore, the recovery of the normal range of motion was slower in the patients with combined Bankart and SLAP lesions (p < 0.05) (Fig. 7).

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