Minimum 10-year clinical and functional outcomes after arthroscopic bony Bankart bridge for the treatment of bony Bankart lesions

Background

Shoulder dislocations may lead to anterior glenoid rim fractures. An all-arthroscopic double-row repair, referred to as the bony Bankart bridge (BBB), has been proposed with superior biomechanical properties when compared to single-row repair techniques. The aim of the present study was to evaluate the minimum 10-year clinical and functional outcomes following BBB.

Methods

All consecutive patients who underwent arthroscopic BBB for the treatment of shoulder instability with an associated bony Bankart lesion by a single surgeon between December 2007 and February 2013 were eligible for inclusion. Preoperatively and minimum 10 years postoperatively, patient-reported outcome measures (American Shoulder and Elbow Surgeons score, short version of the Disabilities of the Arm, Shoulder, and Hand questionnaire, Single Assessment Numeric Evaluation, 12-Item Short-Form Health Survey Physical Component Summary, satisfaction with the postoperative result [1-10 scale with “10” indicating maximum satisfaction], and visual analog scale for pain), return to sport rates, and instability recurrence and revision surgery rates were evaluated.

Results

Eleven patients (100% male) with a mean age at the time of surgery of 48.0 (interquartile range: 31.0-62.0) years were evaluated 14.0 (11.0-14.0) years postoperatively. At long-term follow-up, significant improvements in shoulder function (American Shoulder and Elbow Surgeons score: 74.9 [30.8-90.8] vs. 100 [98.3-100], P < .001; Quick Disabilities of the Arm, Shoulder, and Hand: 13.6 [10.0-63.6] vs. 0.0 [0.0-6.8], P = .002; Single Assessment Numeric Evaluation: 50.0 [19.0-90.0] vs. 96.0 [89.0-99.0], P = .002) and physical health (12-Item Short-Form Health Survey Physical Component Summary: 44.1 [35.1-55.7] vs. 57.3 [56.5-58.5], P < .001) were observed. Median satisfaction with the postoperative outcome was high (10 [5.0-10]). Pain levels were low (visual analog scale for pain: 0 [0-0]). Ten patients reported their postoperative sporting activity level with the majority patients reporting sporting activity levels equal to or above (70.0%) their preinjury level. One patient (9.1%) reported a shoulder redislocation during follow-up. No patients underwent further surgery for instability or post-traumatic osteoarthritis.

Conclusion

The arthroscopic BBB for patients with bony Bankart lesions is associated with excellent shoulder function, low pain levels, and high return to sport rates at long-term follow-up. One patient suffered a shoulder redislocation, but did not require revision surgery. No patients underwent further surgery for post-traumatic osteoarthritis during follow-up.