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Arthroscopic Bankart Repair Using the Labral Bridge Technique Reveals Excellent Outcomes at a Minimum Follow-up of 2
Jakob E Schanda1,2,3, Fabian M Tomanek4,5, Sebastian Conner-Rilk5,6
1Department of Orthopedics and Trauma Surgery, AUVA Trauma Center Vienna-Meidling, Vienna, Austria.
Background:
Despite technical advancements, recurrent glenohumeral joint instability after surgical treatment is still a major issue. Challenging conventional arthroscopic Bankart repair, the labral bridge technique provides an even labral compression to the glenoid rim, potentially enabling anatomic healing and lasting stability.
Purpose:
To evaluate clinical outcomes after arthroscopic Bankart repair using the labral bridge technique at a short-term follow-up.
Study Design:
Case series; Level of evidence, 4.
Methods:
Patients aged 18 to 50 years with traumatic first-time or recurrent shoulder dislocation treated with the arthroscopic labral bridge technique and an early motion rehabilitation protocol were consecutively included. Exclusion criteria were concomitant fractures, bony defects >10%, multidirectional shoulder instability, previous shoulder surgery, epilepsy, or chronic alcohol or drug abuse. Postoperative shoulder stability was assessed using the Rowe score. Patient-reported outcome measures, including the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and Visual Analog Scale (VAS) for pain were evaluated preoperatively and after a minimum of 2 years.
Results:
A total of 46 patients (mean age, 28.9 ± 9.0 years) were included. At the final follow-up (mean, 35.8 ± 10.3 months), 2 patients (4.3%) experienced a recurrent traumatic anterior dislocation. The Rowe score improved significantly with lasting stability compared to preoperative levels (mean, 93.0 ± 16.7 postoperatively vs 37.8 ± 15.2 preoperatively; P < .001). Except for a significant improvement in forward flexion by 10.5° (P = .013), no differences in postoperative range of motion were observed compared to preoperative levels. The ASES score, SANE, and VAS for pain improved significantly compared to preoperative levels (all P < .001). The minimal clinically important difference was reached by 92.7% of patients for the Rowe score, 92.9% for the ASES score, 83.3% for the SANE, and 73.8% for the VAS for pain. The patient acceptable symptom state was achieved by 92.9% of patients for the ASES score, 83.3% for the SANE, and 97.6% for the VAS for pain.
Conclusion:
Arthroscopic Bankart repair with the labral bridge technique for the treatment of anterior shoulder instability demonstrates a low recurrent shoulder instability rate and significant improvements in clinical and functional outcomes at a minimum follow-up of 2 years.
