A biomechanical analysis of a single-row suture anchor fixation of a large bony bankart lesion.

Abstract

PURPOSE:

This study was conducted to assess whether a single-row suture anchor repair of a bony Bankart lesion comprising 19% of the glenoid length restores peak translational force and glenoid depth compared with the intact shoulder.

METHODS:

Nine thawed adult cadaveric shoulders were dissected and mounted in 45° of abduction and 30° of external rotation. A bony Bankart lesion was simulated with an anterior longitudinal osteotomy, parallel to the superoinferior axis of the glenoid, equivalent to 19% of the glenoid length. The humeral head was displaced 10 mm anteriorly at a speed of 2 mm/s with a 50-N compressive load applied. Testing was performed with the glenoid intact, a simulated lesion, and the lesion repaired with 3 single-row suture anchors. Median (interquartile range [IQR]) peak translational force and glenoid depth were reported. The Friedman test and post hoc comparisons with the Wilcoxon signed rank test were used for between-group analyses.

RESULTS:

Peak translational force decreased after osteotomy (13.7 N; IQR, 9.6 to 15.5 N; P = .01) and increased after the repair (18.3 N; IQR, 18.3 to 20.6 N; P = .01) compared with the intact shoulder (23.7 N; IQR, 16.4 to 29.9 N). Glenoid depth significantly decreased after the osteotomy (0.2 mm; IQR, -0.6 to 0.7 mm) compared with baseline (1.7 mm; IQR, 1.3 to 2.0 mm; P = .01) and increased after repair (0.8 mm; IQR, 0.1 to 1.0 mm; P = .03) compared with the osteotomized shoulder. The glenoid depth of the repair was less than the baseline value (P = .01).

CONCLUSIONS:

Repair of an anterior bony Bankart lesion equivalent to 19% of the glenoid length with 3 suture anchors restored the peak translational force needed to anteriorly displace the humerus relative to the glenoid; however, this technique failed to restore the natural glenoid depth in a laboratory setting.

CLINICAL RELEVANCE:

Our findings describe the inability of a single-row suture anchor repair to provide anatomic fixation of the bony Bankart lesion equivalent to 19% of the glenoid length.

• Authors: Evgeny Dyskin, John M Marzo, Craig Howard, Mark Ehrensberger
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 30 Issue 12 Pg. 1562-8 (Dec 2014) ISSN: 1526-3231 [Electronic] United States
• PMID: 25150408 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Inc.

Topics

• Aged
• Aged, 80 and over
• Biomechanical Phenomena
• Cadaver
• Female
• Humans
• Humeral Head
• Joint Instability (etiology, surgery)
• Male
• Middle Aged
• Osteotomy (methods)
• Rotation
• Shoulder Dislocation (surgery)
• Shoulder Fractures (physiopathology, surgery)
• Shoulder Injuries
• Shoulder Joint (surgery)
• Suture Anchors