Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study
Authors: Carlo Fabbriciani, M.D., Giuseppe Milano, M.D., Antonio Demontis, M.D., Salvatore Fadda, M.D., Fabio Ziranu, M.D., Pier Damiano Mulas, M.D.
References: Arthroscopy 2004 May;20(5):456-62.
Abstract
PURPOSE: The purpose of this study was to compare the results of
arthroscopic and open repair of isolated Bankart lesions of the shoulder
using metallic suture anchors. TYPE OF STUDY: Prospective randomized
clinical study. METHODS: Sixty patients with traumatic anterior shoulder
instability underwent a surgical repair of an isolated Bankart lesion. The
patients were divided into 2 groups of 30 patients each. In group 1, an
arthroscopic repair was performed, and in group 2, an open procedure was
performed. The groups were homogeneous for gender, age, dominance, number
of dislocations, time elapsed between first dislocation and surgery, and
pathologic findings. In all cases of both groups, the lesion was repaired
using metallic suture anchors carrying nonabsorbable braided sutures.
Postoperative rehabilitation was the same for the 2 groups. Two years'
follow-up evaluation included Constant and Rowe shoulder scores.
Statistical analysis of data was performed using an unpaired t test
(significance for P <.05). RESULTS: No recurrence of dislocation of the
involved shoulder has been reported in either group. Follow-up Constant
and Rowe scores of the 2 groups were not significantly different. The only
significant difference seen between the 2 groups was for range of motion
evaluation with the Constant score. The mean value for group 1 (39.6 +/-
0.8) was significantly greater (P =.017) than that for group 2 (37.8 +/-
2.0). CONCLUSIONS: Arthroscopic repair with suture anchors is an effective
surgical technique for the treatment of an isolated Bankart lesion. Open
repair does not offer a significantly better 2-year result in terms of
stability, and furthermore, can negatively affect the recovery of full
range of motion of the shoulder. LEVEL OF EVIDENCE: Level I.