Purpose
The objective of this study was to compare the functional assessments of arthroscopy
and open repair for treating Bankart lesion in traumatic anterior shoulder instability.
Methods
Fifty adult patients, aged less than 40 years, with traumatic anterior shoulder instability
and the presence of an isolated Bankart lesion confirmed by diagnostic arthroscopy
were included in the study. They were randomly assigned to receive open or arthroscopic
treatment of an isolated Bankart lesion. In all cases of both groups, the lesion was
repaired with metallic suture anchors. The primary outcomes included the Disabilities
of the Arm, Shoulder and Hand (DASH) questionnaire.
Results
After a mean follow-up period of 37.5 months, 42 patients were evaluated. On the DASH
scale, there was a statistically significant difference favorable to the patients
treated with the arthroscopic technique, but without clinical relevance. There was
no difference in the assessments by University of California, Los Angeles and Rowe
scales. There was no statistically significant difference regarding complications
and failures, as well as range of motion, for the 2 techniques.
Conclusions
On the basis of this study, the open and arthroscopic techniques were effective in
the treatment of traumatic anterior shoulder instability. The arthroscopic technique
showed a lower index of functional limitation of the upper limb, as assessed by the
DASH questionnaire; this, however, was not clinically relevant.
Level of Evidence
Level II, randomized controlled trial.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The pathology and treatment of recurrent dislocation of the shoulder joint.Br J Surg. 1938; 26: 23-29
- The Bankart procedure: A long-term end-result study.J Bone Joint Surg Am. 1978; 60: 1-16
- Bankart repair for anterior instability of the shoulder.J Bone Joint Surg Am. 1998; 80: 1083-1084
- Open capsular repair without bone block for recurrent anterior shoulder instability in patients with and without bony defects of the glenoid and/or humeral head.Am J Sports Med. 2008; 36: 1805-1812
- Arthroscopic versus open Bankart repair: Analysis of patient subjective outcome and cost.Arthroscopy. 2005; 21: 1219-1222
- Arthroscopic versus open Bankart procedures: A comparison of early morbidity and complications.Arthroscopy. 1993; 9: 371-374
- Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study.Arthroscopy. 2004; 20: 456-462
- Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder: A meta-analysis.Am J Sports Med. 2004; 32: 1520-1527
- Arthroscopic versus open repair for traumatic anterior shoulder instability: A meta-analysis.Arthroscopy. 2005; 21: 652-658
- Is arthroscopic surgery for stabilisation of chronic shoulder instability as effective as open surgery?.J Bone Joint Surg Br. 2007; 89: 1188-1196
- Arthroscopic compared with open repairs for recurrent anterior shoulder instability.J Bone Joint Surg Am. 2007; 89: 244-254
- A meta-analysis of open versus arthroscopic Bankart repair using suture anchors.Knee Surg Sports Traumatol Arthrosc. 2010; 18: 1742-1747
- Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.Arthroscopy. 2000; 16: 677-694
- SLAP lesions of the shoulder.Arthroscopy. 1990; 6: 274-279
- Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder and Hand) [corrected].Am J Ind Med. 1996; 29: 602-608
- Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire.Braz J Med Biol Res. 2005; 38: 293-302
- Practical evaluation and management of the shoulder.Ed 1. Saunders, Philadelphia1994
- Shoulder arthroscopy.Ed 2. McGraw-Hill, New York1996
- Tradução e adaptação cultural do Modified-University of California at Los Angeles Shoulder Rating Scale para a língua portuguesa.Rev Bras Reumatol. 2006; 46: 246-252
- A clinical method of functional assessment of the shoulder.Clin Orthop Relat Res. 1987; : 160-164
- Arthroscopic versus open reconstruction of the shoulder in patients with isolated Bankart lesions.Am J Sports Med. 1996; 24: 144-148
- Results of arthroscopic versus open Bankart suture repair.Clin Orthop Relat Res. 1997; : 111-117
- Comparison of shoulder stabilization using arthroscopic transglenoid sutures versus open capsulolabral repairs: A 5-year minimum follow-up.Am J Sports Med. 2004; 32: 650-654
- Surgical interventions for anterior shoulder instability in adults.Cochrane Database Syst Rev. 2009; 7 (CD005077)
- Arthroscopic versus open shoulder stabilization for recurrent anterior instability: A prospective randomized clinical trial.Am J Sports Med. 2006; 34: 1730-1737
- Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder.J Bone Joint Surg Am. 1980; 62: 897-908
- Arthroscopic repair of primary anterior dislocations of the shoulder.Tech Shoulder Elbow Surg. 2001; 2: 2-16
- Measuring shoulder function: A systematic review of four questionnaires.Arthritis Rheum. 2009; 61: 623-632
- Comparison between metal and biodegradable suture anchors in arthroscopic treatment of traumatic anterior shoulder instability: A prospective randomized study.Knee Sports Traumatol Arthrosc. 2010; 18: 1785-1791
- Arthroscopic stabilization of the shoulder: A prospective randomized study of absorbable versus nonabsorbable suture anchors.Arthroscopy. 2006; 22: 716-720
- Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: A prospective study.J Shoulder Elbow Surg. 1999; 8: 66-74
- Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion.Arthroscopy. 2008; 24: 1277-1283
Article Info
Publication History
Published online: February 20, 2012
Accepted:
November 22,
2011
Received:
May 2,
2011
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.