Summary

Comparable outcomes between Double-row double pulley technique and Single-row Bony Bankart repair

Abstract

Background

Acute bony Bankart lesions can be successfully treated with an arthroscopic approach to secure the avulsed bone fragment to the anatomic glenoid surface

Purpose

To analyze the clinical outcomes between two arthroscopic techniques (Single row technique and Double row double pulley technique) for treating shoulder instability resulting from bony Bankart lesions.

Method

A retrospective analysis was conducted on patients diagnosed with bony Bankart lesions between 2013 and 2023. A total of 29 patients, each with a minimum follow-up of 12 months, were included in the evaluation. Among them, 10 patients underwent conventional single-row repair, while 19 patients underwent double-row double pulley techniques. Data on gender, age, duration before surgery, number of dislocations, size of bony fragments, operation time, pre-operative shoulder range of motion, post-operative shoulder range of motion, functional scores (Rowe score, UCLA score, ASES score, and Constant score) at 3 months, 6 months, and 1-year post-operation, as well as healing rate and complications, were collected for analysis.

Result: At the final one-year follow-up, there were no statistically significant differences in forward flexion, abduction, and external rotation between the single-row and double-row double pulley groups. However, both groups exhibited a decrease in internal rotation, with a mean of 80° in the single-row repair group and 70° in the double-row double pulley group. Additionally, there were no significant differences in functional scores between the two groups at the final follow-up. Regarding complications, one (10%) patient in the single-row group and two (10.5%) in the double pulley group experienced traumatic re-dislocation of the affected shoulder.

Conclusion

Both the single-row and modified double-row double pulley techniques have demonstrated efficacy in treating acute bony Bankart lesions. These techniques yield favorable clinical outcomes, contributing significantly to the restoration of shoulder range of motion and stability.