Recurrent instability similar with arthroscopic Bankart repair, open bone block procedure
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SAN DIEGO — Results presented at the American Academy of Orthopaedic Surgeons Annual Meeting showed patients who underwent either arthroscopic Bankart repair or open bone block stabilization had similar rates of recurrent instability.
Joshua S. Dines, MD, and colleagues assessed demographics, sports participation, patient reported outcome measures, satisfaction with surgery and recurrent instability among 164 patients younger than 40 years who underwent either arthroscopic Bankart repair or open bone block stabilization between 2016 and 2017.
“Our goal here was to identify the preoperative characteristics that would help us predict recurrent instability,” Dines, attending orthopedic surgeon at Hospital for Special Surgery in New York City, told Healio Orthopedics. “To that point, we looked at glenoid bone loss, we looked at bone loss on the humeral head side, the Hill Sachs lesion and we also looked at the concept called the glenoid track, and we did this via preoperative MRIs or CT scans.”
Dines noted 25% of patients in the bone block stabilization group and 30% of patients in the arthroscopic group experienced recurrent instability. However, Dines said patients in the bone block stabilization group had a higher rate of reoperation and complications at 9% vs. 3% in the arthroscopic group. Predictors of recurrent instability included age younger than 21 years and an intact anterior articular arc of less than 150°, according to Dines.
“Glenoid bone loss was not predictive, which was something that we actually worry about when we are doing these stabilizations,” Dines said. “I think this speaks to some of the limitations of this study which was that it was retrospective. So, there was selection bias where if a patient had significant bone loss going in, that probably led the surgeon to do the open bone block procedure which would mitigate some of the risk of recurrent instability if we did it arthroscopically.”
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Wright-Chisem J, et al. Paper 437. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Aug. 31-Sept. 3, 2021; San Diego.
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