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Arthroscopic bankart repair with the suretac device. part II: experimental observations

  • Jon J.P. Warner
    Correspondence
    Address correspondence and reprint requests to Jon J.P. Warner, M.D., Director, Shoulder Service, Center for Sports Medicine, University of Pittsburgh, 4601 Baum Blvd, Pittsburgh, PA 15213, U.S.A.
    Affiliations
    Shoulder and Sports Medicine Services, the Center for Sports Medicine, Department of Orthopaedic Surgery, the University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Mark D. Miller
    Affiliations
    Shoulder and Sports Medicine Services, the Center for Sports Medicine, Department of Orthopaedic Surgery, the University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Paul Marks
    Affiliations
    Shoulder and Sports Medicine Services, the Center for Sports Medicine, Department of Orthopaedic Surgery, the University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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      Abstract

      Arthroscopic Bankart repair using the Suretac device (Acufex Microsurgical, Mansfield, MA) was developed as an alternative to both the staple and suture repair techniques. While offering some technical advantages compared with these other approaches, it's technical limitations and pitfalls have only been described anecdotally based on the clinical experience of several surgeons. The purpose of this study was to define these limitations and pitfalls. Eight cadaver shoulders underwent arthroscopic Bankart repair using the Suretac device after first arthroscopically creating a Bankart lesion. These shoulders were then dissected to reveal the placement of the Suretacs and the adequacy of the Bankart lesion repair. Glenoids were transected in the transverse plane and embedded in clear methylmethacrylate to show placement of the Suretac device relative to the articular surface. There were several technical errors that occurred: (1) Inadequate abrasion of the anterior and inferior juxta-articular scapular neck; (2) inadequate superior and medial shift of the inferior glenohumeral ligament before placement of the lowest Suretac, (3) medial placement of the Suretac relative to the articular margin; and (4) insufficient capture and compression of capsular tissue by the Suretac device. This procedure is technically difficult and careful attention must be paid to each step of preparation and repair. Recognition of the common errors may help the surgeon to avoid these pitfalls in the clinical situation.

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