4.6 Article

Chondral Damage After Arthroscopic Repair Techniques for Acute Bony Bankart Lesions: A Biomechanical Study

Journal

AMERICAN JOURNAL OF SPORTS MEDICINE
Volume 49, Issue 10, Pages 2743-2750

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/03635465211023758

Keywords

bony Bankart fracture; arthroscopic bony Bankart repair; shoulder instability; cartilage; cartilage cutout

Funding

  1. University of Rochester Department of Orthopaedics and Rehabilitation
  2. Prodigy Surgical Distribution
  3. Tenex Health

Ask authors/readers for more resources

Both single-row and double-row arthroscopic bony Bankart repair techniques resulted in damage to the humeral head articular cartilage in the cadaveric model used in this study. The double-row technique caused significantly more chondral damage compared to the single-row repair.
Background: Bony Bankart lesions can be encountered during treatment of shoulder instability. Current arthroscopic bony Bankart repair techniques involve intra-articular suture placement, but the effect of these repair techniques on the integrity of the humeral head articular surface warrants further investigation. Purpose: To quantify the degree of humeral head articular cartilage damage secondary to current arthroscopic bony Bankart repair techniques in a cadaveric model. Study Design: Controlled laboratory study. Methods: Testing was performed in 13 matched pairs of cadaveric glenoids with simulated bony Bankart fractures, with a defect width of 25% of the glenoid diameter. Half of the fractures were repaired with a double-row technique, while the contralateral glenoids were repaired with a single-row technique. Samples were subjected to 20,000 cycles of internal-external rotation across a 90 degrees arc at 2 Hz after a compressive load of 750 N, or 90% body weight (whichever was less) was applied to simulate wear. Cartilage defects on the humeral head were quantified through a custom MATLAB script. Mean cartilage cutout differences were analyzed by the Wilcoxon rank-sum test. Results: Both single- and double-row repairs showed macroscopic damage. The histomorphometric analysis demonstrated that the double-row technique resulted in a significantly (P =.036) more chondral damage (mean, 57,489.1 mu m(2); SD, 61,262.2 mu m(2)) than the single-row repair (mean, 28,763.5 mu m(2); SD, 24,4990.2 mu m(2)). Conclusion: Both single-row and double-row arthroscopic bony Bankart fixation techniques resulted in damage to the humeral head articular cartilage in the concavity-compression model utilized in this study. The double-row fixation technique resulted in a significantly increased cutout to the humeral head cartilage after simulated wear in this cadaveric model.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.6
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available