One of the first studies to analyze the outcomes of arthroscopic repair according to lesion size suggests small-sized bony Bankart lesions should be treated with a different procedure than lesions measuring 12.5% to 25% of the inferior glenoid width.
“In small Bankart lesions, restoration of capsulolabral soft tissue tension alone may be enough,” whereas in medium lesions, the osseous architecture of the glenoid should be reconstructed for more functional improvement and less pain,” Young-Kyu Kim, MD, and colleagues wrote in their study.
The researchers conducted a minimum 24-month follow-up of 34 patients with small- and medium-sized lesions that were measured by CT and treated arthroscopically. Surgeons performed capsulolabral repair using suture anchors without excision of the bony fragment for 16 small-sized lesions (<12.5% of the inferior glenoid width) and anatomic reduction and fixation using suture anchors for 18 medium-sized lesions (12.5% to 25% of the inferior glenoid width).
Overall, the investigators found the Visual Analog Scale score improved from 1.7 preoperatively to 0.5 at final follow-up (24 months). The mean modified Rowe score also improved from 59 to 91. In the medium-sized lesion group, the mean postoperative Rowe scores increased from 60 to 95 in cases of anatomic reduction compared with an increase from 56 to 76 in cases of nonanatomic reduction. – by Christian Ingram