Arthroscopic Anterior Labral Repair With Capsulorrhaphy and Interval Closure: Surgical Technique

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopy

Background:

• Traumatic anterior labral injuries, known as Bankart lesions, are a primary cause of anterior shoulder instability.
• Arthroscopic anterior labral repair (Bankart repair) aims to reconstruct soft tissues and decrease dislocation risk, but techniques vary.
• This study introduces a novel technique to improve tissue quality and volume in the repair, alongside interval closure, to minimize recurrent instability.

Purpose of the Study:

• To present an enhanced arthroscopic technique for anterior labral repair.
• To improve the quality and volume of incorporated soft tissue during Bankart repair.
• To reduce recurrent anterior shoulder instability rates through advanced surgical methods and interval closure.

Main Methods:

• The procedure involves shoulder arthroscopy in the lateral position using standard posterior and anterior portals.
• Labral and capsular tissues are elevated, the glenoid footprint prepared, and sutures passed using a self-retrieving device.
• Knotless anchors are utilized to secure the capsulolabral tissue to the glenoid, followed by arthroscopic rotator interval closure.

Main Results:

• A review of 38 active patients with over 2 years of follow-up showed improved outcome scores.
• The procedure demonstrated a redislocation rate of 10.5%.
• Two patients required revision surgery for persistent recurrent instability.

Conclusions:

• Arthroscopic anterior labral repair, augmented with capsulorrhaphy and interval closure, is an effective treatment for recurrent anterior shoulder instability.
• The presented technique enhances soft tissue incorporation, contributing to improved stability.
• This method offers a robust soft tissue restraint for glenohumeral instability.