Arthroscopic Bankart repair with and without curettage of the glenoid edge: A prospective, randomized, controlled study

Published:November 26, 2020DOI:https://doi.org/10.1016/j.arthro.2020.11.042

      Purpose

      To determine whether curettage of the cartilage on the glenoid edge in arthroscopic Bankart repair, reduces the postoperative recurrence rate as compared to the non-curetted glenoid.

      Methods

      Between January 2010 and December 2013, 134 patients underwent arthroscopy and stabilization for recurrent anterior dislocation of shoulder. Total 42 patients were excluded. Alternate glenoid edge was curetted in ninety-two patients undergoing arthroscopic Bankart repair. Twelve patients were lost to follow-up. Thereby we had 80 patients which were divided in two groups, curettage & non-curettage, of 40 patients each. In both groups, the Bankart lesion was repaired using minimum 3 bioanchors loaded with non-absorbable braided sutures. Postoperative rehabilitation was the same for the 2 groups. We recorded recurrence of instability, pain, Constant and Rowe shoulder scores. Statistical analysis of data was performed using an unpaired t test (significance for P <0.05).

      Results

      Both the groups were comparable in terms of age, number of dislocations and bone loss. The average follow-up was 7 years 9 months (range 6-10 years). Out of total 40 patients in the curettage group, 6(15%) patients had recurrence of dislocation and none had subluxations, whereas in the non-curettage group 13(32.5%) patients had recurrence of dislocation and 3(7.5%) had subluxations. The difference in postoperative recurrence of instability was statistically significant (p = 0.012). Average Rowe score in curettage group was 83.75(SD±23.28) and 70.13(SD±31.29) in non-curettage group, the p value being statistically significant(0.030).

      Conclusions

      During arthroscopic Bankart repair, curettage of the cartilage on anterior glenoid edge reduces the incidence of postoperative recurrence of instability.
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