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THE VERTICAL APICAL SUTURE BANKART LESION REPAIR FOR ANTEROINFERIOR GLENO-HUMERAL INSTABILITY-TWO TO FIVE YEAR FOLLOW-UP



Abstract

The purpose of this study was to report the results of the vertical apical suture Bankart lesion repair.

Fifty-nine patients (52 men and seven women) with a mean age of twenty-seven years (range, 16–53 years) underwent this procedure. The mean duration of instability was 4 years and mean follow-up was 42 months (minimum of two years).

A laterally based T-shape capsular incision is performed with the horizontal component directed towards the glenoid neck and into the Bankart lesion. A vertical apical suture through the superior and inferior flaps of the Bankart lesion, tighten the anterior structures to allow them to snug onto the convex decorticated surface of the anterior glenoid.

At final review, according to the system of Rowe et al., 94.9% (56 patients) had a rating of good or excellent. Three patients had a recurrent dislocation due to further trauma.

The mean loss of forward elevation was 1 degree, external rotation with the arm at the side was 2.4 degrees and external rotation in 90 degrees abduction was 2.2 degrees. Of forty-four patients participating in sport, thirty-five (79.5%) returned to the same sport at the same level of activity, even returned to the same sport at a reduced level of activity and two patients did not return to sport.

The vertical apical suture repair offers a 94.9 percent success rate in terms of stability, a maintained range of motion and a 79.5% return to pre-injury level of sporting activity. It is technically less demanding than the Bankart procedure. All sutures used are absorbable. Complications related to non-absorbable implants and absorbable anchors and tacks are avoided.

The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN