Summary

Qualitative and Quantitative evaluation of glenoid bone reaction following the implantation of all-soft suture anchors using advanced radiological imaging (Computed tomography) done at 6 and 12 months in post-operative period

Abstract

Introduction

Arthroscopic Bankart repair using all-soft suture anchors (ASSAs) is currently being considered as an advanced method in the management of Bankart lesion. Various cross-sectional studies have been conducted to assess the radiological outcomes following the usage of ASSAs. To the best of our knowledge, there is paucity of literature to determine the prevalence and time-dependence of glenoid bone reaction following Arthroscopic Bankart repair on sequential CT scan.

Objective

Our study focused on qualitative and quantitative evaluation of glenoid bone reaction following the implantation of all-soft suture anchors using advanced radiological imaging (Computed tomography) done at 6 and 12 months in post-operative period.

Materials And Methods

We used 43 all-soft suture anchors (24 single-loaded and 19 double-loaded) in 15 patients managed by arthroscopic Bankart repair. The suture anchors were assessed radiologically using computed tomography at regular intervals (six and twelve months). The peri-implant changes (Glenoid Bone reactions) in the post-operative period were assessed and quantified as per the study conducted by Tompane T et al and Ruiz Iban MA et al. Quantification of glenoid bone reactions were graded as Grade 0 being complete resolution of the drilled tunnel, Partial defects or erosions (grade 1), Tunnel dilation (grade 2) and peri-anchor cystic changes (grade 3).

Results

In our study, none of the anchors showed complete resorption (grade 0). Partial bony defect or erosions (grade1) were identified in 14 out of 43 anchors (32.56%) and 21 out of 43 anchors (48.84%) in the first and second CT done at 6 months and 12 months respectively. We found tunnel dilation (grade 2) in 26 anchors (66.46%) in first CT which reduced to 19 (44.19%) in the second CT. 3 peri-anchor cystic lesions (grade 3) were identified in the first CT which remained the same on subsequent serial imaging.
The results of our study in the first follow-up (6th month) were comparable to the cross-sectional studies conducted by Tompane T et al and Ruiz Iban MA et al, who reported an increased incidence of tunnel dilation following the usage of ASSAs. We found increased conversion rates of glenoid reactions from grade 2 to grade 1 upon serial evaluation.

Conclusion

Performance of all soft suture anchors upon serial radiological assessment (CT based) showed some changes in the glenoid bone. Grade 1 changes were increased from 32.56% patients at 6 months to 48.84% patients at 1 year. Grade 2 changes were improved from 60.46% to 44.19% patients at 1-year follow-up following insertion which showed a tendency towards healing on serial evaluation. However, the grade 3 changes remained constant throughout. We would advocate further long-term studies to evaluate the healing potential of glenoid bone reaction.