Follow-up computed tomography arthrographic evaluation of bony Bankart lesions after arthroscopic repair

Arthroscopy. 2012 Apr;28(4):465-73. doi: 10.1016/j.arthro.2011.09.008. Epub 2012 Jan 20.

Abstract

Purpose: The follow-up results of bony union after an arthroscopic bony Bankart repair have not been reported. We studied follow-up computed tomography (CT) arthrograms to evaluate radiographic healing of bony Bankart fragments.

Methods: Among 41 patients who underwent arthroscopy for a bony Bankart lesion between July 2006 and May 2009, 31 cases in 30 patients who had undergone sequential follow-up CT arthrography preoperatively, at 3 months postoperatively, and at 1 year postoperatively were enrolled. Radiologic patterns of fracture healing were classified into bony healing and fibrous healing. The mean age was 23.4 years, and the mean follow-up was 30.5 months. The mean interval from the first trauma to surgery was 32.5 months, and the mean preoperative dislocation number was 12.1.

Results: The mean preoperative glenoid defect was 14.1%. The fracture healing patterns included 26 bony and 5 fibrous unions. There was a significant positive relation between the total dislocation number and the preoperative glenoid defect (P = .003). The proportion of the mean fragment dimension to a circle drawn through the outer cortex of the inferior glenoid was 8.4% preoperatively, 6.6% at 3 months postoperatively, and 6.2% at 1 year postoperatively. The fragment size decreased from that measured preoperatively to the size measured 3 months after surgery (P < .05). However, the fragment size was maintained between 3 months and 1 year postoperatively (P > .05). The mean Rowe score at 1 year postoperatively was 97.2.

Conclusions: Follow-up CT arthrographic evaluation showed that small bony Bankart fragments survived without resorption until 1 year postoperatively, even with fibrous union, and that reattached bone fragment fixation to the anatomic position with the labrum could survive.

Level of evidence: Level IV, therapeutic case series.

Publication types

  • Evaluation Study
  • Video-Audio Media

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy* / rehabilitation
  • Female
  • Follow-Up Studies
  • Fracture Healing*
  • Glenoid Cavity / diagnostic imaging
  • Glenoid Cavity / injuries*
  • Glenoid Cavity / surgery
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Retrospective Studies
  • Shoulder Dislocation / complications*
  • Shoulder Fractures / diagnostic imaging
  • Shoulder Fractures / etiology
  • Shoulder Fractures / rehabilitation
  • Shoulder Fractures / surgery*
  • Treatment Outcome
  • Young Adult