gms | German Medical Science

Objectives: Glenohumeral instability may lead to anterior glenoid rim fractures. An all-arthroscopic double-row repair, so-called bony Bankart bridge, has been proposed as the preferred method of fixation with superior biomechanical properties compared to single-row repair techniques. It was the aim of the present study to evaluate the long-term clinical and functional outcomes, with a special focus on recurrent instability and revision surgery following bony Bankart bridge.

Methods: All consecutive patients that underwent bony Bankart bridge for the treatment of shoulder instability with an associated bony Bankart fracture by a single surgeon between 12/2007 and 02/2013 were eligible for inclusion. Patients were included with minimum 10 years follow-up. Patient-reported outcome measures (short version of the Disabilities of the Arm, Shoulder and Hand [QuickDASH] questionnaire, American Shoulder and Elbow Surgeons [ASES] Score, Single Assessment Numeric Evaluation [SANE], Visual Analog Scale [VAS] for pain, and 12-Item Short-Form Health Survey Physical Component Summary [SF-12 PCS]), patient satisfaction (1–10 scale with “10” indicating maximum satisfaction), return to sport, instability recurrence and revision surgery were evaluated.

Results and conclusion: Eleven patients (100% male) were evaluated with a mean follow-up of 12.9 ± SD 1.8 years. The mean age at the time of surgery was 46 ± 16.7 years. Shoulder function (QuickDASH: 0.0 [interquartile range: 0.0–6.8], ASES Score: 100 [98.3–100], SANE: 96.0 [89.0–99.0]) was excellent and pain levels were low at final follow-up (VAS for pain: 0 [0–0]). Overall physical health improved significantly from pre- to postoperatively (SF-12 PCS: 41.3 [31.8–55.7]) vs. 57.3 [56.5–58.5], p=0.046). Median satisfaction with the postoperative outcome was 10 [9–10]). Ten patients reported their postoperative sporting activity level with 70% returning to sporting activity at same level and 20% returning to sport below their pre-injury level. Instability recurrence was reported by three patients (27.3%). Revision surgery was not performed in any patient. The arthroscopic bony Bankart bridge for patients with anterior bony Bankart fractures is associated with excellent shoulder function, low pain levels and return to sport rates at long-term follow-up. Three of 11 patients reported experienced instability recurrence postoperatively but did not undergo further surgery. As pain levels were low and no further surgery was performed at long-term follow-up, the likelihood of post-traumatic osteoarthritis is low. Overall, the bony Bankart bridge has shown to be effective, safe and durable for the treatment of bony Bankart lesions.